Provider Demographics
NPI:1164199295
Name:BUSEN, LAURA LEIGH (RN BSN CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEIGH
Last Name:BUSEN
Suffix:
Gender:F
Credentials:RN BSN CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:CARLETON
Mailing Address - State:MI
Mailing Address - Zip Code:48117-0045
Mailing Address - Country:US
Mailing Address - Phone:734-770-9837
Mailing Address - Fax:734-201-1794
Practice Address - Street 1:11489 MARTINSVILLE RD
Practice Address - Street 2:
Practice Address - City:CARLETON
Practice Address - State:MI
Practice Address - Zip Code:48117-9568
Practice Address - Country:US
Practice Address - Phone:734-770-9837
Practice Address - Fax:734-201-1794
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704222292163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse