Provider Demographics
NPI:1104044973
Name:TUSH, BETH (R N)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:TUSH
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 BEECH GROVE CT
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1855
Mailing Address - Country:US
Mailing Address - Phone:410-987-1095
Mailing Address - Fax:
Practice Address - Street 1:310 GOVERNOR STONE PKWY
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-2433
Practice Address - Country:US
Practice Address - Phone:410-222-3851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR127710163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool