Individual
MISS GWEN BUSSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
350 W WOODROW WILSON AVE, JACKSON, MS 39213-7681
(601) 709-5160
Mailing address
PO BOX 3437, JACKSON, MS 39207-3437
(601) 362-5321
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R131530
MS
Other
Enumeration date
10/02/2006
Last updated
06/07/2011
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