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General NPI Number Information
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NPI Number | 1760872162
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Entity Type | Individual
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Provider Name | ANGELA LYNN BUSHEY ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2015
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 310 RACETRACK RD NW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1553
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Country | US
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Telephone | 810-889-4550
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5040
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City | OROVILLE
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State | CA
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Zip | 95966-0040
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95120946
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9289436
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License Number State | FL
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