Provider Demographics
NPI:1508341934
Name:BUSH, RACHEL (MSN, CPNP-AC/PC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BUSH
Suffix:
Gender:F
Credentials:MSN, CPNP-AC/PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:DIVISION OF TRANSPLANT SURGERY BOX 100118
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0286
Mailing Address - Country:US
Mailing Address - Phone:352-265-0754
Mailing Address - Fax:352-265-0154
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:DIVISION OF TRANSPLANT SURGERY
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0286
Practice Address - Country:US
Practice Address - Phone:352-265-0754
Practice Address - Fax:352-265-0154
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9369667363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101453000Medicaid