Healthcare Provider Details

I. General information

NPI: 1679911622
Provider Name (Legal Business Name): CASSIE FAY BUSCH ROSE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSIE FAY BUSCH

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 NORTH 7TH STREET
BISMARCK ND
58501-4436
US

IV. Provider business mailing address

222 NORTH 7TH STREET
BISMARCK ND
58501-4436
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-5202
  • Fax: 701-323-5369
Mailing address:
  • Phone: 701-323-5202
  • Fax: 701-323-5369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR35677
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: