Provider Demographics
NPI:1073115697
Name:RUSH, KARLEIGH M (PA-C)
Entity type:Individual
Prefix:
First Name:KARLEIGH
Middle Name:M
Last Name:RUSH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:NAVAL HOSPITAL CAMP PENDLETON
Mailing Address - Street 2:200 MERCY CIRCLE DR
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92055
Mailing Address - Country:US
Mailing Address - Phone:760-725-2142
Mailing Address - Fax:760-725-2927
Practice Address - Street 1:NMRTC CAMP PENDLETON
Practice Address - Street 2:200 MERCY CIRCLE
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-2142
Practice Address - Fax:760-725-2927
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001010873363A00000X
CAPA63779363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant