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General NPI Number Information
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NPI Number | 1437615523
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Entity Type | Individual
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Provider Name | LASTACIA BUSH APRN
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Gender | Female
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 7599 W SAND LAKE RD
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City | ORLANDO
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State | FL
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Zip | 32819-5109
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Country | US
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Telephone | 407-352-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 7599 W SAND LAKE RD
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City | ORLANDO
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State | FL
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Zip | 32819-5109
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Country | US
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Telephone | 407-352-1177
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 9374281
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 9374281
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9374281
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number | 9374281
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 9374281
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 9374281
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number | 9374281
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 9374281
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 9374281
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License Number State | FL
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11022488
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License Number State | FL
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