Provider Demographics
NPI:1942508114
Name:RUSHING, ANNIE P (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:P
Last Name:RUSHING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ELIOT ST
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-7121
Mailing Address - Country:US
Mailing Address - Phone:914-720-0792
Mailing Address - Fax:
Practice Address - Street 1:1 ELIOT ST
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-7121
Practice Address - Country:US
Practice Address - Phone:914-720-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070304-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse