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Individual

HOPE VICTORIA BUSSENIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N, M.N, F.N.P-C

Contact information

Practice address
657 ATHENS ST, JEFFERSON, GA 30549-1474
(706) 367-7302
Mailing address
718 BUCK TRL, HOSCHTON, GA 30548-2189
(706) 367-7302

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R100015
GA
363LF0000X
Family Nurse Practitioner
Primary
R100015
GA
363LP2300X
Primary Care Nurse Practitioner
R100015
GA
363LW0102X
Women's Health Nurse Practitioner
R100015
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
85001597G
GA
Enumeration date
10/13/2007
Last updated
10/13/2007
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