Individual
MR. STEPHEN CHARLES CUSHING
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1615 MAPLE LANE, ASHLAND, WI 54806
(715) 682-4563
(815) 685-5108
Mailing address
PO BOX 1547, SEDALIA, MO 65302
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
R1122657
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43291500
—
WI
05
—
4437860
—
MI
Enumeration date
04/17/2006
Last updated
07/08/2007
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