Provider Demographics
NPI:1487172177
Name:METZGER-RUSH, ELVIRA (PA-C)
Entity type:Individual
Prefix:
First Name:ELVIRA
Middle Name:
Last Name:METZGER-RUSH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:WILLIE
Other - Middle Name:
Other - Last Name:RUSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:925 E MCDOWELL ROAD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2502
Mailing Address - Country:US
Mailing Address - Phone:602-521-3700
Mailing Address - Fax:602-521-3701
Practice Address - Street 1:925 E MCDOWELL ROAD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2502
Practice Address - Country:US
Practice Address - Phone:602-521-3700
Practice Address - Fax:602-521-3701
Is Sole Proprietor?:No
Enumeration Date:2017-09-02
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60917007363AM0700X
AZ9531363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical