| Doctor Name: | MRS. GWENDOLYN HENDRIX-BUSH |
| NPI Number: | 1568437812 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 1150 |
| Business Practice Address: | 2204 E Main St Stigler, OK - 744622822 |
| Business Phone Number: | 9189679200 |
| Business Fax Number: | |
| Mailing Address: | 906 Nw 7th St, P. O. Box 593 STIGLER |
| State: | OK |
| Postal Code: | 744621504 |
| Phone Number: | 9189679200 |
| Fax Number: | |
| NPI Enumeration Date: | 02/21/2006 |
| NPI Last Update Date: | 06/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1150 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |