Provider Demographics
NPI:1417449844
Name:RUSH, KATHERINE ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ANN
Last Name:RUSH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NE TUDOR RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5600
Mailing Address - Country:US
Mailing Address - Phone:816-607-3747
Mailing Address - Fax:816-607-3590
Practice Address - Street 1:100 NE TUDOR RD STE 105
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5600
Practice Address - Country:US
Practice Address - Phone:816-607-3747
Practice Address - Fax:816-607-3590
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116747225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist