Individual
ABBY A RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
300 FIRST CAPITOL DR, ST CHARLES, MO 63301
(314) 821-1256
(314) 821-1239
Mailing address
13515 BARRETT PARKWAY DR, SUITE 170, BALLWIN, MO 63021-5870
(314) 775-2816
(314) 775-2821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2006028431
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
916819303
—
MO
01
—
P00384697
RR MEDICARE
MO
Enumeration date
10/12/2006
Last updated
10/09/2012
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