Provider Demographics
NPI:1770444879
Name:BUSS, MICHELLE ANNE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANNE
Last Name:BUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2190 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:BOELUS
Mailing Address - State:NE
Mailing Address - Zip Code:68820-2707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2190 2ND AVE
Practice Address - Street 2:
Practice Address - City:BOELUS
Practice Address - State:NE
Practice Address - Zip Code:68820-2707
Practice Address - Country:US
Practice Address - Phone:308-833-0842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion