Individual provider · NPI-1

Lastacia Bush, APRN

Nurse Practitioner, Family · Orlando, FL

NPI number1437615523
StatusActive
Last updated in NPPESNov 16, 2022

Details

NPI
1437615523
Entity type
Individual (NPI-1)
Name
Lastacia Bush
Credential
APRN
Sex
Female
Sole proprietor
No
Enumeration date
Feb 14, 2019
Certification date
Nov 16, 2022
Last updated
Nov 16, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family11022488FLYes
163WH0200X Registered Nurse, Home Health9374281FL
163WP0200X Registered Nurse, Pediatrics9374281FL
163W00000X Registered Nurse9374281FL
163WR0400X Registered Nurse, Rehabilitation9374281FL
163WW0000X Registered Nurse, Wound Care9374281FL
372600000X Adult Companion9374281FL
373H00000X Day Training/Habilitation Specialist9374281FL
374U00000X Home Health Aide9374281FL
376K00000X Nurse's Aide9374281FL

Other names

  • Lastacia Bush (Former Name)

Practice location

7599 W Sand Lake Rd
Orlando, FL 32819-5109

Phone 407-352-1177

Mailing address

7599 W Sand Lake Rd
Orlando, FL 32819-5109

Phone 407-352-1177

Other practice locations

713 Doby Ave
Orlando, FL 32805-3046

Phone 386-983-0154

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