Provider Demographics
NPI:1548595945
Name:BUZBY, LINDA SUE (CNM)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:BUZBY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:405 HURFFVILLE CROSSKEYS RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9340
Mailing Address - Country:US
Mailing Address - Phone:856-589-1414
Mailing Address - Fax:856-256-5772
Practice Address - Street 1:405 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9340
Practice Address - Country:US
Practice Address - Phone:856-589-1414
Practice Address - Fax:856-256-5772
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00050601163WX0002X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500638202Medicaid