MEDICARE: ALEXUS ANN BUSHEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	085.007531	IL
2	363AM0700X	Medical Physician Assistant	1152525	OH

General Provider Information

NPI Number	:	1255807400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXUS ANN BUSHEE

Provider Business Mailing Address
First Line	:	104 WOODMONT BLVD STE 500
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-2245
Country	:	US
Telephone Number	:	412-508-9937
Fax Number	:

Provider Business Practice Location Address
First Line	:	6900 PEARL RD STE 200
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3640
Country	:	US
Telephone Number	:	440-845-0900
Fax Number	:	440-845-7355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2018
Last Update Date	:	01/29/2025

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Directions to “ ALEXUS ANN BUSHEE ” Practice Location

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