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Individual

WENDY P BUSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
615 RIDGE RD, ROXBORO, NC 27573-4629
(336) 599-2121
Mailing address
615 RIDGE RD, ROXBORO, NC 27573-4629
(336) 599-2121

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
145693
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
145693
CRNA LICENSE NUMBER
NC
Enumeration date
05/16/2006
Last updated
10/04/2007
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