Individual
DIANA M BUSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1880 N FRONTAGE RD, HASTINGS, MN 55033-2687
(651) 438-1800
(651) 438-1894
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9030
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
733826100
—
MN
Enumeration date
05/08/2006
Last updated
03/22/2021
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