Individual
STEPHANIE LEA BUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741
(605) 720-7000
Mailing address
5604 BLUE STEM CT., RAPID CITY, SD 57702
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000589
SD
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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