Provider Demographics
NPI:1891566287
Name:BUSH, CATHERINE MARIE (MED LEVEL, PCT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:BUSH
Suffix:
Gender:F
Credentials:MED LEVEL, PCT
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:N/A
Mailing Address - Street 1:9824 RHYTHM DR # A
Mailing Address - Street 2:
Mailing Address - City:OVERLAND
Mailing Address - State:MO
Mailing Address - Zip Code:63114-2521
Mailing Address - Country:US
Mailing Address - Phone:314-791-6366
Mailing Address - Fax:314-936-1477
Practice Address - Street 1:9824 RHYTHM DR # A
Practice Address - Street 2:
Practice Address - City:OVERLAND
Practice Address - State:MO
Practice Address - Zip Code:63114-2521
Practice Address - Country:US
Practice Address - Phone:314-791-6366
Practice Address - Fax:314-936-1477
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide