Provider Demographics
NPI:1871573873
Name:BUSHFIELD-KAHAN, MARCEE (FNP)
Entity type:Individual
Prefix:
First Name:MARCEE
Middle Name:
Last Name:BUSHFIELD-KAHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 E FORT LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3920
Mailing Address - Country:US
Mailing Address - Phone:520-888-2435
Mailing Address - Fax:520-888-7618
Practice Address - Street 1:137 E FORT LOWELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3920
Practice Address - Country:US
Practice Address - Phone:520-888-2435
Practice Address - Fax:520-888-7618
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN085314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ382622Medicaid
103707Medicare ID - Type Unspecified
AZ382622Medicaid
AZ120856Medicare UPIN