Provider Demographics
NPI:1477893105
Name:BUSHINSKI, SUSAN LYNNE (DNP)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LYNNE
Last Name:BUSHINSKI
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:LYNNE
Other - Last Name:BARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:44697 GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-5162
Mailing Address - Country:US
Mailing Address - Phone:734-740-0598
Mailing Address - Fax:
Practice Address - Street 1:44697 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-5162
Practice Address - Country:US
Practice Address - Phone:734-740-0598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-16
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704256515363LF0000X
VA0024164425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024164425OtherVIRGINIA BOARD OF NURSING
MI4704256515OtherMICHIGAN BOARD OF NURSING