Provider Demographics
NPI:1346016391
Name:BUSSELL, SHAIN LENAE (CBCS)
Entity Type:Individual
Prefix:
First Name:SHAIN
Middle Name:LENAE
Last Name:BUSSELL
Suffix:
Gender:F
Credentials:CBCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16553 W CIELO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-1411
Mailing Address - Country:US
Mailing Address - Phone:623-703-6180
Mailing Address - Fax:
Practice Address - Street 1:16553 W CIELO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85387-1411
Practice Address - Country:US
Practice Address - Phone:623-703-6180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
M9B3F2E2OtherBILLING AND CODING SPECIALIST