Provider Demographics
NPI:1245534577
Name:HENRY-BUSH, FRANCES L
Entity type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:L
Last Name:HENRY-BUSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 ERNEST ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351-3222
Mailing Address - Country:US
Mailing Address - Phone:850-875-4089
Mailing Address - Fax:
Practice Address - Street 1:501 S BOLIVAR ST
Practice Address - Street 2:
Practice Address - City:CHATTAHOOCHEE
Practice Address - State:FL
Practice Address - Zip Code:32324-1347
Practice Address - Country:US
Practice Address - Phone:850-663-4374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL85858-2363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health