Provider Demographics
NPI:1902608912
Name:BUSCH, TATYANA SHANIA (APRN)
Entity type:Individual
Prefix:
First Name:TATYANA
Middle Name:SHANIA
Last Name:BUSCH
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:TATYANA
Other - Middle Name:SHANIA
Other - Last Name:OLIVER-WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4476 SW 49TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-9682
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7350 SW 60TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-6475
Practice Address - Country:US
Practice Address - Phone:352-854-5530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038376363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner