Healthcare Provider Details

I. General information

NPI: 1023323342
Provider Name (Legal Business Name): STEPHANIE S RUSHING FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE SUZANNE SMITH

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 KOHLERS XING STE 230
KYLE TX
78640-2475
US

IV. Provider business mailing address

844 KOHLERS XING STE 230
KYLE TX
78640-2475
US

V. Phone/Fax

Practice location:
  • Phone: 737-404-3926
  • Fax: 737-404-3918
Mailing address:
  • Phone: 737-404-3926
  • Fax: 737-404-3918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN218375
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-105754
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1049834
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: