Provider Demographics
NPI:1396893756
Name:BUSHEK GREVE, BARBARA J (RN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:BUSHEK GREVE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:BRUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2225 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53083
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:808 DELAWARE AVE APT A
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-9469
Practice Address - Country:US
Practice Address - Phone:262-375-7039
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI86939163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse