Individual
THERESA HARRINGTON STUKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8318 ARLINGTON BLVD STE 305, FAIRFAX, VA 22031-5218
(703) 207-4323
Mailing address
8318 ARLINGTON BLVD STE 305, FAIRFAX, VA 22031-5218
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
RN61810
DC
363LA2200X
Adult Health Nurse Practitioner
Primary
0024165377
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00678664
RAILROAD MEDICARE
DC
Enumeration date
12/14/2005
Last updated
01/08/2013
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