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Individual
MAURA DUSSMAN
Active
Individual
MAURA DUSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209024152
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134129323
—
IL
05
—
1720048580
—
IL
05
—
1811998263
—
IL
05
—
1851391809
—
IL
Enumeration date
10/15/2021
Last updated
10/15/2021
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