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NPI Code Detail

MEDICARE: KELLILYN RUSH

MEDICARE: KELLILYN RUSH
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
1363A00000XPhysician Assistant50.009036RXOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831947100
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLILYN RUSH
Provider Business Mailing Address
First Line : 3000 ARLINGTON AVE STOP 1108
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2595
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3000 ARLINGTON AVE STE 2C
Second Line :
City : TOLEDO
State : OH
Zip : 43614-2595
Country : US
Telephone Number : 419-383-3759
Fax Number : 419-383-2962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2024
Last Update Date : 04/07/2026

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Directions to “ KELLILYN RUSH ” Practice Location

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