Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 44510 | KS |
N | 363L00000X | Nurse Practitioner | 44510 | KS |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 74547 | KS |
NPI | 1134124084 |
---|---|
Provider Name | Ruth E Busch |
First Address | Wichita, KS 67206-3405 |
Second Address | Wichita, KS 67206-3405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100301990B | (05) | KS |
S45212 | (02) | KS |