Provider Demographics
NPI:1750941803
Name:BUSS, JACQUELINE M (CRNP)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:M
Last Name:BUSS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:M
Other - Last Name:HERBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:519 S 5TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-1061
Mailing Address - Country:US
Mailing Address - Phone:215-257-8601
Mailing Address - Fax:215-257-8619
Practice Address - Street 1:5 QUAKERS WAY
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-2754
Practice Address - Country:US
Practice Address - Phone:215-536-0655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018465363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care