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General NPI Number Information
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NPI Number | 1902732696
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Entity Type | Individual
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Provider Name | TANNER BUSACKER NRP
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Gender | Male
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Dates
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Enumeration Date | 06/20/2026
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Last Update Date | 06/20/2026
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Provider Practice Location Address
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Address Line | 62980 BOYD ACRES RD
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City | BEND
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State | OR
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Zip | 97701-8289
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Country | US
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Telephone | 541-639-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 4107 E OVERLAND RD UNIT B202
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City | MERIDIAN
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State | ID
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Zip | 83642-8400
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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 | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 82953
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 83032
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | AZ00013748
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 22508036
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License Number State | AK
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Taxonomy #5
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 210241
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License Number State | OR
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