Provider Demographics
NPI:1407201825
Name:BUSH, TRISHA LEE (RN)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:LEE
Last Name:BUSH
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:PO BOX 1208
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81402-1208
Mailing Address - Country:US
Mailing Address - Phone:970-252-3200
Mailing Address - Fax:970-252-3208
Practice Address - Street 1:605 E MIAMI
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4108
Practice Address - Country:US
Practice Address - Phone:970-249-9694
Practice Address - Fax:970-249-2955
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN0174565163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health