Michelle Denise Bush, RN, MSN, CRNP-BC
Individual provider Active NPI Family Nurse Practitioner · Locust Grove, GA
NPI 1154450484 · NPPES record last updated Jan 25, 2017
Key facts
- NPI
- 1154450484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN256477 (GA)
- Practice address
- 3758 Highway 42
Locust Grove, GA 30248-3653 - Phone
- (678) 561-9430
- Fax
- (770) 914-1070
- NPI assigned
- Mar 4, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170224001041 | GA | Practitioner - Nurse Practitioner | 5890759120 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aylo Health, LLC | Past | Accepting new patients | |
| Aylo Health, LLC | Past | Accepting new patients | |
| Aylo Health, LLC | Past | Accepting new patients | |
| James B. Nagle, M.D., Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN256477 | GA | Yes |
Addresses
Primary practice location
3758 Highway 42
Locust Grove, GA 30248-3653
Mailing address
3758 Highway 42
Locust Grove, GA 30248-3653
Phone (678) 561-9430
Other providers in Locust Grove, GA
- Bridging the Process Counseling & Consulting Services
- Brown Signature Transportation and More LLC
- Carla Meshannon Brown
- Cierra Nicole Davis Brown
- Amy Bartley Burghardt
- Business Enterprise
- Hope M Canty
- Carenova Inc
- Mahlory Carey
- Erica Zanae Carmouche
All providers in Locust Grove, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.