Individual
BRENDA D. BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
12747 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141-6269
(314) 582-4398
(314) 582-4408
Mailing address
12747 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141-6269
(314) 582-4398
(314) 582-4408
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2009012212
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2019008150
MO
Other
Enumeration date
12/01/2008
Last updated
01/21/2021
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