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General NPI Number Information
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NPI Number | 1093354458
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Entity Type | Individual
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Provider Name | AMBER LANAE BUSBY RN
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Gender | Female
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 1700 HIGHWAY 78 E
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City | JASPER
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State | AL
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Zip | 35501-4036
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Country | US
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Telephone | 205-512-1058
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Fax |
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Provider Business Mailing Address
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Address Line | 1861 TOMMY ROBINSON RD
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City | JASPER
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State | AL
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Zip | 35504-6644
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Country | US
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Telephone | 205-275-5554
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-129220
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-129220
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License Number State | AL
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