Healthcare Provider Details

I. General information

NPI: 1841183126
Provider Name (Legal Business Name): VERONICA VANBUSKIRK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 E BOULEVARD
KOKOMO IN
46902-2401
US

IV. Provider business mailing address

17103 LINDA WAY
NOBLESVILLE IN
46062-7128
US

V. Phone/Fax

Practice location:
  • Phone: 765-416-8480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: