Rebecca Ann Bush, ND
Individual provider Active NPI Naturopath · Stillwater, MN
NPI 1407064975 · NPPES record last updated May 16, 2014
Key facts
- NPI
- 1407064975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 1011 (MN)
- Practice address
- 105 New England PL
Suite 220
Stillwater, MN 55082-5783 - Phone
- (651) 342-1043
- Fax
- (866) 462-6742
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 1011 | MN | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Socialvite, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1011 | MN | Yes |
Addresses
Primary practice location
105 New England PL
Suite 220
Stillwater, MN 55082-5783
Mailing address
105 New England PL
Suite 220
Stillwater, MN 55082-5783
Phone (651) 342-1043
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1011 | Other | MN | MN STATE MEDICAL BOARD |
Other providers in Stillwater, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 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.