Provider Demographics
NPI:1710348107
Name:BUSH, STEPHANIE (FNP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BUSH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E AUDIE MURPHY PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-2713
Mailing Address - Country:US
Mailing Address - Phone:972-782-5043
Mailing Address - Fax:972-435-4374
Practice Address - Street 1:301 E AUDIE MURPHY PKWY STE B
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442-2713
Practice Address - Country:US
Practice Address - Phone:729-782-5043
Practice Address - Fax:972-435-4374
Is Sole Proprietor?:No
Enumeration Date:2016-03-11
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130276363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily