Provider Demographics
NPI:1790382893
Name:BUSH, EYRONE MORGAN (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:EYRONE
Middle Name:MORGAN
Last Name:BUSH
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:LANA
Other - Middle Name:EYRONE
Other - Last Name:BUSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, APRN, FNP-BC
Mailing Address - Street 1:10929 NW 32ND PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4955
Mailing Address - Country:US
Mailing Address - Phone:352-256-4846
Mailing Address - Fax:
Practice Address - Street 1:3720 NW 83RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-5603
Practice Address - Country:US
Practice Address - Phone:352-336-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2159212163W00000X
FLAPRN11003631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse