Provider Demographics
NPI:1104044213
Name:RUSHFORD, KAREN A (CNM)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:RUSHFORD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 SINGLETON RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9154
Mailing Address - Country:US
Mailing Address - Phone:843-349-0100
Mailing Address - Fax:843-349-0104
Practice Address - Street 1:660 SINGLETON RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9154
Practice Address - Country:US
Practice Address - Phone:843-349-0100
Practice Address - Fax:843-349-0104
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCR49175207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP19319Medicare UPIN