Provider Demographics
NPI:1003683954
Name:RUSH, KATHERINE (APRN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:RUSH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 STEER ST
Mailing Address - Street 2:
Mailing Address - City:GROVER
Mailing Address - State:NC
Mailing Address - Zip Code:28073-9702
Mailing Address - Country:US
Mailing Address - Phone:704-747-4281
Mailing Address - Fax:
Practice Address - Street 1:107 STEER ST
Practice Address - Street 2:
Practice Address - City:GROVER
Practice Address - State:NC
Practice Address - Zip Code:28073-9702
Practice Address - Country:US
Practice Address - Phone:704-747-4281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC581364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist