Provider Demographics
NPI:1164075131
Name:BUSBY-DREWEK, RACHEL CHRISTINA
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:CHRISTINA
Last Name:BUSBY-DREWEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 BLUEBELL PL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-6231
Mailing Address - Country:US
Mailing Address - Phone:850-509-3400
Mailing Address - Fax:
Practice Address - Street 1:2009 MICCOSUKEE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5359
Practice Address - Country:US
Practice Address - Phone:850-942-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily