Individual
STEPHANIE LYNN BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
160 GATEWAY DR, WAUPUN, WI 53963
(920) 324-9899
(920) 324-9899
Mailing address
160 GATEWAY DR, WAUPUN, WI 53963-2276
(920) 324-9899
(920) 324-9899
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8779-33
WI
363LF0000X
Family Nurse Practitioner
Primary
8779
WI
Other
Enumeration date
10/18/2018
Last updated
09/20/2022
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