MEDICARE: CAROLINE RUSHING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7233	TN

General Provider Information

NPI Number	:	1265047500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE RUSHING

Provider Business Mailing Address
First Line	:	4121 LONG LEAF DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-2327
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4121 LONG LEAF DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-2327
Country	:	US
Telephone Number	:	731-487-5444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2020
Last Update Date	:	09/14/2020

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Directions to “ CAROLINE RUSHING ” Practice Location

Language	Start Address	Practice Location

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