Healthcare Provider Details

I. General information

NPI: 1447913207
Provider Name (Legal Business Name): LINDSEY MICHELE RUSH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W MAIN ST
MT STERLING IL
62353-1224
US

IV. Provider business mailing address

108 W MAIN ST
MT STERLING IL
62353-1224
US

V. Phone/Fax

Practice location:
  • Phone: 217-773-6060
  • Fax:
Mailing address:
  • Phone: 172-773-6060
  • Fax: 217-406-8319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209024140
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.005833
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2021038565
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number377.005185
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: