Kelly Bush

Individual provider Active NPI Licensed Practical Nurse · Flushing, MI

NPI 1669955357 · NPPES record last updated Sep 10, 2018

Key facts

NPI
1669955357
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703092351 (MI)
Practice address
2521 N Elms Rd
Flushing, MI 48433-9423
Phone
(810) 487-5571
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703092351MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703092351 MI Yes

Addresses

Primary practice location

2521 N Elms Rd
Flushing, MI 48433-9423

Mailing address

2521 N Elms Rd
Flushing, MI 48433-9423
Phone (810) 487-5571

Other providers in Flushing, MI

All providers in Flushing, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.