Provider Demographics
NPI:1275784126
Name:RUSH, IRENE C (RN)
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:C
Last Name:RUSH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-2742
Mailing Address - Country:US
Mailing Address - Phone:401-785-1316
Mailing Address - Fax:
Practice Address - Street 1:276 ADAMS ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-2742
Practice Address - Country:US
Practice Address - Phone:401-785-1316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN36250163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator