Tammie S Bush, LPN
Individual provider Active NPI Licensed Practical Nurse · Moravia, NY
NPI 1134526205 · NPPES record last updated Dec 4, 2014
Key facts
- NPI
- 1134526205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 256208-1 (NY)
- Practice address
- 5437 Sayles Corners Rd
Moravia, NY 13118-2259 - Phone
- (315) 209-0840
- NPI assigned
- Dec 4, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 256208-1 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 256208-1 | NY | Yes |
Addresses
Primary practice location
5437 Sayles Corners Rd
Moravia, NY 13118-2259
Mailing address
5437 Sayles Corners Rd
Moravia, NY 13118-2259
Phone (315) 209-0840
Other providers in Moravia, NY
- Erica Faye Babcock
- Meredith Bodah
- Heather Cameron
- Carol Clark
- Arthur H Combs
- De-Anne Jeanne Cook
- Erica Christin Cornell
All providers in Moravia, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.