Individual
MRS. JEANNE MAUDLIN RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 742-4131
Mailing address
PO BOX 387, PORTAGE, WI 53901-0387
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110003043
VA
Other
Enumeration date
07/28/2009
Last updated
06/20/2013
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