MEDICARE: MS. MARIANNE BUZBY RN, MSN, CRNP

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	163WP0200X	Pediatric Registered Nurse	RN246024L	PA
2	163WP0200X	Pediatric Registered Nurse	26NR06393100	NJ
3	363LP0200X	Pediatric Nurse Practitioner	SP001292D	PA
4	363LP0200X	Pediatric Nurse Practitioner	26NN06393100	NJ

General Provider Information

NPI Number	:	1558316661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIANNE BUZBY RN, MSN, CRNP

Provider Business Mailing Address
First Line	:	221 WAYNE AVE
Second Line	:
City	:	HADDONFIELD
State	:	NJ
Zip	:	08033-1449
Country	:	US
Telephone Number	:	856-428-5860
Fax Number	:

Provider Business Practice Location Address
First Line	:	34TH ST. & CIVIC CTR BLVD, THE CHILDRENS HOSP. OF PHILA
Second Line	:	DIVISION OF ENDOCRINOLOGY, 11NW, SUITE 30
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104
Country	:	US
Telephone Number	:	215-590-3174
Fax Number	:	215-590-3053

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	12/26/2014

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