Provider Demographics
NPI:1902684012
Name:BUSBY, MEGAN BRYANT (NP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:BRYANT
Last Name:BUSBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:RUTH
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5675 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-1617
Mailing Address - Country:US
Mailing Address - Phone:251-445-4440
Mailing Address - Fax:251-445-4435
Practice Address - Street 1:5675 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36619-1617
Practice Address - Country:US
Practice Address - Phone:251-445-4440
Practice Address - Fax:251-445-4435
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-202395208000000X
MS905699363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics