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General NPI Number Information
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NPI Number | 1578979936
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Entity Type | Individual
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Provider Name | KRISTEN ELIZABETH BUSH PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 315 19TH ST SE BLDG 100
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City | HICKORY
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State | NC
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Zip | 28602-4230
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Country | US
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Telephone | 828-325-9849
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Fax | 828-325-9879
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Provider Business Mailing Address
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Address Line | 1072 X RAY DR
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City | GASTONIA
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State | NC
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Zip | 28054-7488
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Country | US
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Telephone | 980-399-6330
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Fax | 704-671-1095
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-05741
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-05741
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License Number State | NC
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