Healthcare Provider Details

I. General information

NPI: 1073521712
Provider Name (Legal Business Name): JAMES EDWARD BUZZARD APRN, BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 30TH ST
DES MOINES IA
50310-5753
US

IV. Provider business mailing address

5967 N WINWOOD DR
JOHNSTON IA
50131-1613
US

V. Phone/Fax

Practice location:
  • Phone: 515-699-5999
  • Fax: 515-699-5525
Mailing address:
  • Phone: 515-278-8653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberH-097863
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: