Individual
EMILY BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
4625 MUSTANG DR, FORT WORTH, TX 76137-5640
(214) 635-9550
Mailing address
4625 MUSTANG DR, FORT WORTH, TX 76137-5640
(214) 635-9550
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
336442
TX
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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