Provider Demographics
NPI:1902321151
Name:RUSH, MAUREEN (ARNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:RUSH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85602-6608
Mailing Address - Country:US
Mailing Address - Phone:267-664-1470
Mailing Address - Fax:
Practice Address - Street 1:200 S REX ALLEN JR RD
Practice Address - Street 2:
Practice Address - City:WILLCOX
Practice Address - State:AZ
Practice Address - Zip Code:85643-1331
Practice Address - Country:US
Practice Address - Phone:267-664-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ300615363LF0000X
PASP018326363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ300615OtherAPRN