Provider Demographics
NPI:1902997133
Name:BUSCH, DEBORAH (PNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BUSCH
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1754
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1754
Mailing Address - Country:US
Mailing Address - Phone:610-798-4500
Mailing Address - Fax:
Practice Address - Street 1:401 N 17TH ST
Practice Address - Street 2:SUITE 311
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5034
Practice Address - Country:US
Practice Address - Phone:610-821-4920
Practice Address - Fax:610-821-1358
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP005658363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics