Provider Demographics
NPI:1740881374
Name:BUSHEY, KATELYN MARY (MSN, RN, ACNS-BC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARY
Last Name:BUSHEY
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Gender:F
Credentials:MSN, RN, ACNS-BC
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Mailing Address - Street 1:118 RIVERWAY APT 32
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4130
Mailing Address - Country:US
Mailing Address - Phone:413-297-4058
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:857-238-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA32539071364SN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SN0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeuroscience