Provider Demographics
NPI:1053511204
Name:BUSCH, JILLIAN LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:LEIGH
Last Name:BUSCH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2813 ZENDT DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6217
Mailing Address - Country:US
Mailing Address - Phone:970-480-7220
Mailing Address - Fax:720-815-0268
Practice Address - Street 1:2629 REDWING RD STE 295
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6316
Practice Address - Country:US
Practice Address - Phone:970-480-7220
Practice Address - Fax:720-815-0268
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI55402-0202084P0800X
IL036.1190672084P0800X
WY16300A2084P0800X
CO475702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry