Provider Demographics
NPI:1902871601
Name:BUSSEY, DARLA G (CRNA)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:G
Last Name:BUSSEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30684 O'BANION LANE
Mailing Address - Street 2:
Mailing Address - City:PRATHER
Mailing Address - State:CA
Mailing Address - Zip Code:93651
Mailing Address - Country:US
Mailing Address - Phone:559-855-3326
Mailing Address - Fax:
Practice Address - Street 1:30684 OBANION LN
Practice Address - Street 2:
Practice Address - City:PRATHER
Practice Address - State:CA
Practice Address - Zip Code:93651-9633
Practice Address - Country:US
Practice Address - Phone:559-855-3326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA2058367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered