Provider Demographics
NPI:1053795757
Name:BUSH, EMILY (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:BUSH
Suffix:
Gender:
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 DINSLEY PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-7422
Mailing Address - Country:US
Mailing Address - Phone:937-397-0177
Mailing Address - Fax:
Practice Address - Street 1:300 COLLEGE PARK GOSIGER HALL ROOM 110
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45469-2679
Practice Address - Country:US
Practice Address - Phone:937-229-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17554-NP363LF0000X
OHAPRNCNP17554363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily