Provider Demographics
NPI:1366511198
Name:KADUSHIN, ADRIANNE CAROL (RN CSP APRN PMH)
Entity type:Individual
Prefix:MRS
First Name:ADRIANNE
Middle Name:CAROL
Last Name:KADUSHIN
Suffix:
Gender:F
Credentials:RN CSP APRN PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 KAY AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7121
Mailing Address - Country:US
Mailing Address - Phone:410-749-0507
Mailing Address - Fax:410-543-2638
Practice Address - Street 1:206 KAY AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7121
Practice Address - Country:US
Practice Address - Phone:410-749-0507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR049236163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
975RMedicare ID - Type Unspecified