Provider Demographics
NPI:1689901357
Name:RUSHING, CRYSTAL (QBHP)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:RUSHING
Suffix:
Gender:F
Credentials:QBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 SHOEMAKER RD STE D
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-3000
Mailing Address - Country:US
Mailing Address - Phone:870-917-2171
Mailing Address - Fax:870-917-2161
Practice Address - Street 1:1933 SHOEMAKER RD STE D
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-3000
Practice Address - Country:US
Practice Address - Phone:870-917-2171
Practice Address - Fax:870-917-2161
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist