Provider Demographics
NPI:1164902946
Name:BUSSARD, VALERIE (NP-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:BUSSARD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:DAWN
Other - Last Name:KOLSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3201 S 7 HWY
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-5301
Mailing Address - Country:US
Mailing Address - Phone:816-220-2302
Mailing Address - Fax:
Practice Address - Street 1:3201 S 7 HWY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-5301
Practice Address - Country:US
Practice Address - Phone:816-220-2302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018025959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily