Provider Demographics
NPI:1427804707
Name:TUSHAUS, BOBBI JO (RN)
Entity type:Individual
Prefix:MRS
First Name:BOBBI
Middle Name:JO
Last Name:TUSHAUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 E HIGHWAY 7 STE 100
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265-1701
Mailing Address - Country:US
Mailing Address - Phone:320-269-2929
Mailing Address - Fax:
Practice Address - Street 1:1505 E HIGHWAY 7 STE 100
Practice Address - Street 2:
Practice Address - City:MONTEVIDEO
Practice Address - State:MN
Practice Address - Zip Code:56265-1701
Practice Address - Country:US
Practice Address - Phone:320-269-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR187138-0163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health