Shanshan Elissa Gustafson is a student in an organized health care education training program in Gaithersburg, MD. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Shanshan Elissa Gustafson NPI is 1417537259. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
655 WATKINS MILL RD FL 5
GAITHERSBURG, MD
ZIP 20879-301
Phone: (240) 632-4021
The NPI 1417537259 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 4/14/2021 and was last updated on 7/10/2023.