Provider Demographics
NPI:1477937894
Name:BUSEY, MELANIE (APRN)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:BUSEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 OAK ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVALE
Mailing Address - State:ME
Mailing Address - Zip Code:04083-1926
Mailing Address - Country:US
Mailing Address - Phone:207-490-6900
Mailing Address - Fax:
Practice Address - Street 1:15 OAK ST
Practice Address - Street 2:
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1926
Practice Address - Country:US
Practice Address - Phone:207-490-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2024-09-24
Deactivation Date:2023-06-12
Deactivation Code:
Reactivation Date:2023-07-13
Provider Licenses
StateLicense IDTaxonomies
NH045430-23363LF0000X
IL209.022559363LF0000X
GARN217707363LF0000X
VT101.0134807363LF0000X
MECNP191022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily