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Individual

MS. LORETTA L BUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9000 W WISCONSIN AVE, PEDIATRIC ENDOCRINOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-7650
(414) 266-6749
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC ENDOCRINOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-7650
(414) 266-6749

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2591
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
039906261V
HUMANA
05
1669423059
WI
Enumeration date
05/12/2006
Last updated
02/11/2013
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