Individual
CHANEL BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5757 N 36TH ST, MILWAUKEE, WI 53209-4007
(346) 450-4784
Mailing address
5757 N 36TH ST, MILWAUKEE, WI 53209-4007
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
61467112
WA
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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