Provider Demographics
NPI:1255048039
Name:BUSBY, KEARSTY (FNP-C)
Entity type:Individual
Prefix:
First Name:KEARSTY
Middle Name:
Last Name:BUSBY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3836 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-5429
Mailing Address - Country:US
Mailing Address - Phone:903-408-0114
Mailing Address - Fax:
Practice Address - Street 1:6257 FM 2642 BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-3224
Practice Address - Country:US
Practice Address - Phone:469-800-3670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1091067363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily