1740421569 NPI number — MRS. JACQUELINE BUSBY ZAUNER NP

Table of content: MRS. JACQUELINE BUSBY ZAUNER NP (NPI 1740421569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740421569 NPI number — MRS. JACQUELINE BUSBY ZAUNER NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAUNER
Provider First Name:
JACQUELINE
Provider Middle Name:
BUSBY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZAUNER
Provider Other First Name:
JACQUELIN
Provider Other Middle Name:
ANNETTE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740421569
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1004 N HIGHLAND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURFREESBORO
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37130-2454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-893-4480
Provider Business Mailing Address Fax Number:
615-867-7945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1004 N HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURFREESBORO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37130-2454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-893-4480
Provider Business Practice Location Address Fax Number:
615-867-7945
Provider Enumeration Date:
03/09/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  RN0000165863 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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