Provider Demographics
NPI:1740449057
Name:BUSBY, NANCY JEPSEN (NP)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JEPSEN
Last Name:BUSBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 CHATHAM AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:LA
Mailing Address - Zip Code:71226-8917
Mailing Address - Country:US
Mailing Address - Phone:318-249-3200
Mailing Address - Fax:318-249-3204
Practice Address - Street 1:804 CHATHAM AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:LA
Practice Address - Zip Code:71226-8917
Practice Address - Country:US
Practice Address - Phone:318-249-3200
Practice Address - Fax:318-249-3204
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP05020OtherSTATE LICENSE