MEDICARE: MS. MONICA LEIGH BUSH CRNP

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	363LF0000X	Family Nurse Practitioner	1-053800	AL
2	363LX0106X	Occupational Health Nurse Practitioner	1-053800	AL
3	363LX0106X	Occupational Health Nurse Practitioner	3008002	KY
4	363LF0000X	Family Nurse Practitioner	1-53800	AL

General Provider Information

NPI Number	:	1316131345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONICA LEIGH BUSH CRNP

Provider Business Mailing Address
First Line	:	2424 HALIFAX PL SW
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-7337
Country	:	US
Telephone Number	:	256-280-8209
Fax Number	:

Provider Business Practice Location Address
First Line	:	1304 13TH AVE SE STE A
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-4316
Country	:	US
Telephone Number	:	256-280-8209
Fax Number	:

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

Provider Enumeration Date	:	09/03/2007
Last Update Date	:	12/23/2021

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