Koreen Cuffee

Individual provider Active NPI Registered Nurse · Bristow, VA

NPI 1083299804 · NPPES record last updated Mar 12, 2021

Key facts

NPI
1083299804
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
0001106508 (VA)
Practice address
12162 Drum Salute PL
Bristow, VA 20136-1935
Phone
(703) 915-1483
NPI assigned
Mar 12, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0001106508VAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001106508 VA Yes

Addresses

Primary practice location

12162 Drum Salute PL
Bristow, VA 20136-1935

Mailing address

12162 Drum Salute PL
Bristow, VA 20136-1935

Other providers in Bristow, VA

All providers in Bristow, VA · Registered Nurse in Virginia

Sources for this page

Verify at the official NPI Registry.