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Individual
MS. LORETTA L BUSH
Active
Individual
MS. LORETTA L BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2591
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039906261V
HUMANA
—
05
—
1669423059
—
WI
Enumeration date
05/12/2006
Last updated
02/11/2013
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