Individual
MS. AMY JO BUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6650 CUMBERLAND GAP PKWY, HARROGATE, TN 37752-8012
(423) 526-7988
Mailing address
PO BOX 44, HARROGATE, TN 37752-0044
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008011
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100269880
—
KY
05
—
Q014334
—
TN
Enumeration date
04/15/2013
Last updated
11/15/2022
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