Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APN0000012137 | TN |
NPI | 1003006396 |
---|---|
Provider Name | Michelle L Rush |
First Address | Memphis, TN 38148-0001 |
Second Address | Memphis, TN 38104-3534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 01/08/2007 |