Provider Demographics
NPI:1780896670
Name:RUSHFORTH, CAROLINE BARTHOLOMEW (RN, FNP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:BARTHOLOMEW
Last Name:RUSHFORTH
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
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Mailing Address - Street 1:39 GOODRICH ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1165
Mailing Address - Country:US
Mailing Address - Phone:315-386-3389
Mailing Address - Fax:
Practice Address - Street 1:DAVIS HEALTH CENTER SUNY CANTON
Practice Address - Street 2:34 CORNELL AVE
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617
Practice Address - Country:US
Practice Address - Phone:315-386-7333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY425661-1163WS0200X
NYF330556-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool