Provider Demographics
NPI:1659648707
Name:BUSSELL, PENELOPE (BA, CD(DONA))
Entity Type:Individual
Prefix:
First Name:PENELOPE
Middle Name:
Last Name:BUSSELL
Suffix:
Gender:F
Credentials:BA, CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BELLE GLADES LN
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4521
Mailing Address - Country:US
Mailing Address - Phone:908-281-0339
Mailing Address - Fax:
Practice Address - Street 1:17 BELLE GLADES LN
Practice Address - Street 2:
Practice Address - City:BELLE MEAD
Practice Address - State:NJ
Practice Address - Zip Code:08502-4521
Practice Address - Country:US
Practice Address - Phone:908-281-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula