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General NPI Number Information
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NPI Number | 1386373082
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Entity Type | Individual
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Provider Name | MICHAEL K. RUSHING FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 5565 WOODBINE RD STE 3
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City | PACE
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State | FL
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Zip | 32571
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Country | US
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Telephone | 850-290-5615
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Fax | 850-290-5615
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Provider Business Mailing Address
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Address Line | 4565 CARMEL CIR
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City | PACE
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State | FL
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Zip | 32571-1164
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Country | US
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Telephone | 850-572-4901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | GAA-NP001381
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0100823-C-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11020222
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-115204
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1116322
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 31802
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 115830
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License Number State | WV
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