Doctor Name: | LAURA CHRISTINA BUSH |
NPI Number: | 1548541550 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CFNP |
License Number: | CNP-01842 |
Business Practice Address: | 120 S 9th St Belen, NM - 870023102 |
Business Phone Number: | 5058611013 |
Business Fax Number: | |
Mailing Address: | 4804 Haines Ave Ne, ALBUQUERQUE |
State: | NM |
Postal Code: | 871105009 |
Phone Number: | 8584421274 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2011 |
NPI Last Update Date: | 11/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP-01842 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |