Individual
ANNETTE BUSHNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3502 JAMES ST, SYRACUSE, NY 13206-2349
(315) 437-4500
Mailing address
3502 JAMES ST, SYRACUSE, NY 13206-2349
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2765851
NY
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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