Basic Information
| Provider Information | |||||||||
| NPI: | 1225564628 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSULA | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | |||||||||
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| Credential: | DNP, RN, AGPCNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5215 LOUGHBORO RD NW #530 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028950050 | ||||||||
| FaxNumber: | 2028950051 | ||||||||
| Practice Location | |||||||||
| Address1: | 12150 ANNAPOLIS RD STE 205 | ||||||||
| Address2: | |||||||||
| City: | GLENN DALE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207699183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018051103 | ||||||||
| FaxNumber: | 3018051104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2017 | ||||||||
| LastUpdateDate: | 06/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | R232351 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LA2200X | R232351 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LA2200X | RN1047050 | DC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LG0600X | 4704286812 | MI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363L00000X | RN1047050 | DC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.