Provider Demographics
NPI:1003338880
Name:BUSSEY, LINDSAY NICOLE ROYAL (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:NICOLE ROYAL
Last Name:BUSSEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:LINDSAY
Other - Middle Name:NICOLE
Other - Last Name:ROYAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:406 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2302
Mailing Address - Country:US
Mailing Address - Phone:410-852-0871
Mailing Address - Fax:
Practice Address - Street 1:201 E UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2829
Practice Address - Country:US
Practice Address - Phone:855-633-0199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR196828363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily