Provider Demographics
NPI:1033710181
Name:BUSEY, AMBER A (CNA, CHAP)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:A
Last Name:BUSEY
Suffix:
Gender:F
Credentials:CNA, CHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 PUNCHEON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-6165
Mailing Address - Country:US
Mailing Address - Phone:615-561-2813
Mailing Address - Fax:
Practice Address - Street 1:1339 PUNCHEON CREEK RD
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-6165
Practice Address - Country:US
Practice Address - Phone:615-561-2813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator