Individual
MRS. TARA DENISE BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
707 LASSITER ST, SMITHFIELD, NC 27577-4613
(919) 209-9856
(919) 209-9859
Mailing address
707 LASSITER ST, SMITHFIELD, NC 27577-4613
(919) 209-9856
(919) 209-9859
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9600390
NC
Other
Enumeration date
11/16/2005
Last updated
09/29/2008
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