MEDICARE: DONNA MARIE RUSH RN

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	163W00000X	Registered Nurse	RN234279	OH

General Provider Information

NPI Number	:	1861740391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA MARIE RUSH RN

Provider Business Mailing Address
First Line	:	3830 E GREENWOOD RD
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701-9564
Country	:	US
Telephone Number	:	740-452-4361
Fax Number	:

Provider Business Practice Location Address
First Line	:	3830 E GREENWOOD RD
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701-9564
Country	:	US
Telephone Number	:	740-452-4361
Fax Number	:

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

Provider Enumeration Date	:	08/15/2012
Last Update Date	:	08/15/2012

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