Doctor Name: | MRS. LAUREN MARIE BUSHMAN |
NPI Number: | 1235522855 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 28197559A |
Business Practice Address: | 6677 Wimbledon Dr Zionsville, IN - 460779152 |
Business Phone Number: | 3174021582 |
Business Fax Number: | |
Mailing Address: | 6677 Wimbledon Dr, ZIONSVILLE |
State: | IN |
Postal Code: | 460779152 |
Phone Number: | 3174021582 |
Fax Number: | |
NPI Enumeration Date: | 03/06/2015 |
NPI Last Update Date: | 03/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 28197559A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |