Provider Demographics
NPI:1285189407
Name:BUSEY, PAULA (RN)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:BUSEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 E DOGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-2423
Mailing Address - Country:US
Mailing Address - Phone:720-935-0211
Mailing Address - Fax:
Practice Address - Street 1:841 E DOGWOOD AVE
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-2423
Practice Address - Country:US
Practice Address - Phone:720-935-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1635835163WH0200X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health