Provider Demographics
NPI:1972189975
Name:BUSH, ALLANA KATHLEEN (NP-C, RN)
Entity type:Individual
Prefix:MRS
First Name:ALLANA
Middle Name:KATHLEEN
Last Name:BUSH
Suffix:
Gender:F
Credentials:NP-C, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5189 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-9524
Mailing Address - Country:US
Mailing Address - Phone:209-966-3631
Mailing Address - Fax:209-846-2043
Practice Address - Street 1:5189 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9524
Practice Address - Country:US
Practice Address - Phone:099-663-6312
Practice Address - Fax:209-846-2043
Is Sole Proprietor?:No
Enumeration Date:2021-03-20
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1106418-30163W00000X
CA95022797163W00000X
OR201705327RN163W00000X
IL041.543152163W00000X
WARN61154884163W00000X
WAAP61154896363LF0000X
OR202102459NP-PP363LF0000X
WI14329-33363LF0000X
CA95016976363LF0000X
IL277.003740363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily