Individual
MS. DEBORAH ANN RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1550 N CRESTMONT DR, SUITE E, MERIDIAN, ID 83642-2184
(208) 288-4200
(208) 288-4279
Mailing address
1550 N CRESTMONT DR, STE A, MERIDIAN, ID 83642-2177
(208) 288-4200
(208) 288-4279
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
N-25920
ID
2084P0802X
Addiction Psychiatry Physician
1268A
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP1268A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12644208
CAQH
ID
05
—
1992858500
—
ID
Enumeration date
03/21/2013
Last updated
02/05/2021
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