Provider Demographics
NPI:1043076003
Name:BUSS, KATLYN JO (MSW)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:JO
Last Name:BUSS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2288 ROAD 105
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-3207
Mailing Address - Country:US
Mailing Address - Phone:970-520-4547
Mailing Address - Fax:
Practice Address - Street 1:2288 ROAD 105
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-3207
Practice Address - Country:US
Practice Address - Phone:970-520-4547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker