Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 865 | SC |
N | 363LN0000X | Nurse Practitioner - Neonatal | 865 | SC |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 865 | SC |
NPI | 1003924051 |
---|---|
Provider Name | Rona S Cushman |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29401-1113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NP0467 | (05) | SC |
Q67412 | (02) |