Individual provider · NPI-1

Kalethia Bush, LPN, CPT, EDDA

Licensed Practical Nurse · Arlington, TX

NPI number1780328799
StatusActive
Last updated in NPPESDec 16, 2024

Details

NPI
1780328799
Entity type
Individual (NPI-1)
Name
Ms. Kalethia Bush
Credential
LPN, CPT, EDDA
Sex
Female
Sole proprietor
No
Enumeration date
Apr 25, 2022
Certification date
Dec 16, 2024
Last updated
Dec 16, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
164W00000X Licensed Practical Nurse30002221LAYes
126800000X Dental Assistant––
171400000X Health & Wellness Coach––
174H00000X Health Educator––
202K00000X PhlebologyY4K7H8M8LA

Practice location

1606 Industrial Ct
Arlington, TX 76011-4726

Phone 972-861-2013 · Fax 214-889-8499

Mailing address

1606 Industrial Ct
Arlington, TX 76011-4726

Phone 318-331-2150 · Fax 214-889-8499

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