Provider Demographics
NPI:1194220004
Name:RUSHING, EMPRESS DEVION (MA)
Entity Type:Individual
Prefix:MS
First Name:EMPRESS
Middle Name:DEVION
Last Name:RUSHING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 DREXEL ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71108-2016
Mailing Address - Country:US
Mailing Address - Phone:318-200-2938
Mailing Address - Fax:
Practice Address - Street 1:3012 DREXEL ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71108-2016
Practice Address - Country:US
Practice Address - Phone:318-200-2938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA82-4908077251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health