Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R196828 | MD |
NPI | 1003338880 |
---|---|
Provider Name | Mrs. Lindsay Nicole Royal Bussey |
First Address | Linthicum Heights, MD 21090-2302 |
Second Address | Baltimore, MD 21218-2829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2017 |
Last Update Date | 12/07/2017 |