MEDICARE: MARIE EDDINS BUSOVSKY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	APN.0997314-NP	CO
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1235882481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE EDDINS BUSOVSKY

Provider Business Mailing Address
First Line	:	4500 E 9TH AVE STE 470
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-3923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 E 9TH AVE STE 470
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-3923
Country	:	US
Telephone Number	:	303-320-8499
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2022
Last Update Date	:	03/02/2026

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