Provider Demographics
NPI:1528423126
Name:KASUMU, MUSBAU (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:MUSBAU
Middle Name:
Last Name:KASUMU
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-3022
Mailing Address - Country:US
Mailing Address - Phone:267-304-2156
Mailing Address - Fax:
Practice Address - Street 1:7401 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-3022
Practice Address - Country:US
Practice Address - Phone:267-304-2156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP015902OtherAPRN CERTIFICATION