Provider Demographics
NPI:1255791182
Name:BUSHONG, TAMMY LYNN (APRN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:BUSHONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 736
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-0736
Mailing Address - Country:US
Mailing Address - Phone:620-820-5800
Mailing Address - Fax:620-820-5821
Practice Address - Street 1:1902 S US HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4948
Practice Address - Country:US
Practice Address - Phone:620-820-5800
Practice Address - Fax:620-820-5821
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS53-77134-121363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily