Provider Demographics
NPI:1932888427
Name:QUEVISON, AYOKO (DNAP, CRNA)
Entity type:Individual
Prefix:
First Name:AYOKO
Middle Name:
Last Name:QUEVISON
Suffix:
Gender:F
Credentials:DNAP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 PENDLETON ST
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5417
Mailing Address - Country:US
Mailing Address - Phone:240-476-9607
Mailing Address - Fax:
Practice Address - Street 1:13700 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5417
Practice Address - Country:US
Practice Address - Phone:240-476-9607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA143125367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered