Provider Demographics
NPI:1134249329
Name:RUSH, JANE CRESWELL (RN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:CRESWELL
Last Name:RUSH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 FOXGLOVE SQ
Mailing Address - Street 2:
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017-1665
Mailing Address - Country:US
Mailing Address - Phone:410-272-7076
Mailing Address - Fax:
Practice Address - Street 1:1 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3592
Practice Address - Country:US
Practice Address - Phone:410-638-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR169225163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse