Individual
CAROL BUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 MAPLE LN STE 1, ASHLAND, WI 54806-3610
(715) 685-7500
Mailing address
1615 MAPLE LN STE 1, ASHLAND, WI 54806-3610
(715) 685-7500
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
152573-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164613527
—
MI
05
—
1164613527
—
MN
05
—
1164613527
—
WI
Enumeration date
08/09/2007
Last updated
05/20/2016
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