Individual
VICKIE L BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
4498 N 1ST AVE, EVANSVILLE, IN 47710-3622
(812) 436-7280
(812) 436-7290
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 436-7280
(812) 436-7290
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001673A
IN
363LF0000X
Family Nurse Practitioner
71001673A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200464740
—
IN
05
—
78011269
—
KY
Enumeration date
08/03/2005
Last updated
06/10/2013
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