Provider Demographics
NPI:1902175151
Name:BUSHER, MINDY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:
Last Name:BUSHER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 PARKHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:VA
Mailing Address - Zip Code:23153-2230
Mailing Address - Country:US
Mailing Address - Phone:804-556-2987
Mailing Address - Fax:
Practice Address - Street 1:2690 PARKHOUSE CT
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:VA
Practice Address - Zip Code:23153-2230
Practice Address - Country:US
Practice Address - Phone:804-556-2987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA0202206254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist