Provider Demographics
NPI:1528944477
Name:ADVANCEDNP
Entity type:Organization
Organization Name:ADVANCEDNP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:ACNP-BC
Authorized Official - Phone:214-620-1145
Mailing Address - Street 1:14601 WOODSHADOW LN
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-7988
Mailing Address - Country:US
Mailing Address - Phone:214-620-1145
Mailing Address - Fax:
Practice Address - Street 1:2112 FORUM PKWY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6028
Practice Address - Country:US
Practice Address - Phone:817-799-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty