Healthcare Provider Details

I. General information

NPI: 1780505297
Provider Name (Legal Business Name): NATHANIEL ALAN BUSS PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 PIRATES CV
PENSACOLA FL
32514-6729
US

IV. Provider business mailing address

8350 PIRATES CV
PENSACOLA FL
32514-6729
US

V. Phone/Fax

Practice location:
  • Phone: 316-293-9356
  • Fax:
Mailing address:
  • Phone: 316-293-9356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11049270
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: