Provider Demographics
NPI:1922830959
Name:CEDILLO, JOSE (DNP, FNP)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:CEDILLO
Suffix:
Gender:M
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 CROYDON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4103
Mailing Address - Country:US
Mailing Address - Phone:619-446-9071
Mailing Address - Fax:
Practice Address - Street 1:2831 15TH ST NW # 7
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4607
Practice Address - Country:US
Practice Address - Phone:202-462-4788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP500019322363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily