Provider Demographics
NPI:1043240807
Name:BUSKILL, DENISE L (APRN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:BUSKILL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:L
Other - Last Name:HACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 950244
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0244
Mailing Address - Country:US
Mailing Address - Phone:502-953-4799
Mailing Address - Fax:502-953-4798
Practice Address - Street 1:9702 STONESTREET RD STE 220
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-6814
Practice Address - Country:US
Practice Address - Phone:502-995-5051
Practice Address - Fax:502-996-8309
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001265A363L00000X
KY3004109363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000600669OtherANTHEM
2730634000OtherPASSPORT ADVANTAGE
50010929OtherPASSPORT
P00216180OtherRAILROAD MEDICARE
KY3691817000OtherPASSPORT ADVANTAGE
IN200359530Medicaid
KY311192100OtherBLACK LUNG
KY50021517OtherPASSPORT
KY78013356Medicaid
KY311192100OtherBLACK LUNG
P73985Medicare UPIN
KY0097195Medicare PIN