Stacie Bush
Individual provider Active NPI Driver · Savannah, GA
NPI 1376224865 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1376224865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 418 N Baldwin Cir
Savannah, GA 31405-3967 - Phone
- (912) 323-1674
- NPI assigned
- Jul 27, 2023
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | GA | Yes |
Addresses
Primary practice location
418 N Baldwin Cir
Savannah, GA 31405-3967
Mailing address
418 N Baldwin Cir
Savannah, GA 31405-3967
Phone (912) 323-1674
Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2023. 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.