Individual
DANIELLE ANNE BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4868 KELLY AVE, ROOTSTOWN, OH 44272-9286
(330) 703-9207
Mailing address
4868 KELLY AVE, ROOTSTOWN, OH 44272-9286
(330) 703-9207
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.133726.MEDS-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN.133726.MEDS-IV
OHIO BOARD OF NURSING
OH
Enumeration date
05/31/2018
Last updated
05/31/2018
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