Provider Demographics
NPI:1023323342
Name:RUSHING, STEPHANIE S (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:S
Last Name:RUSHING
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:SUZANNE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 360340
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-6340
Mailing Address - Country:US
Mailing Address - Phone:512-988-5355
Mailing Address - Fax:512-323-0307
Practice Address - Street 1:5781 KYLE PKWY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6743
Practice Address - Country:US
Practice Address - Phone:512-988-5355
Practice Address - Fax:512-323-0307
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-105754363LF0000X
GARN218375363LF0000X
TX1049834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003119576AMedicaid
GA202I086544Medicare PIN