Healthcare Provider Details

I. General information

NPI: 1477062131
Provider Name (Legal Business Name): SARA E BUSSEY APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-4524
US

IV. Provider business mailing address

PO BOX 100297
GAINESVILLE FL
32610-0297
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7770
  • Fax: 352-273-5927
Mailing address:
  • Phone: 352-273-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9343054
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: