Individual
GARY RUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2959 S 92ND ST, WEST ALLIS, WI 53227-3601
(414) 727-4921
Mailing address
2959 S 92ND ST, WEST ALLIS, WI 53227-3601
(414) 727-4921
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
130673-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130673-030
—
WI
Enumeration date
05/22/2008
Last updated
05/22/2008
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