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NPI Code Detail

MEDICARE: KRYSTAL ANN RUSHING

MEDICARE:   KRYSTAL ANN RUSHING
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
1372600000XAdult Companion
2372500000XChore Provider
33747A0650XAttendant Care Provider
4376J00000XHomemaker
53747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1265088363
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL ANN RUSHING
Provider Business Mailing Address
First Line : 5801 W WASHINGTON AVE APT C
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-4748
Country : US
Telephone Number : 424-266-2133
Fax Number :
Provider Business Practice Location Address
First Line : 5801 W WASHINGTON AVE APT C
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-4748
Country : US
Telephone Number : 424-266-2133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2019
Last Update Date : 08/14/2019

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Directions to “ KRYSTAL ANN RUSHING ” Practice Location

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