Healthcare Provider Details

I. General information

NPI: 1922507771
Provider Name (Legal Business Name): AMY BUZARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22868 ROUTE 68 STE 5
CLARION PA
16214-8566
US

IV. Provider business mailing address

22868 ROUTE 68 STE 5
CLARION PA
16214-8566
US

V. Phone/Fax

Practice location:
  • Phone: 814-227-2941
  • Fax: 814-227-2946
Mailing address:
  • Phone: 814-227-2941
  • Fax: 814-227-2946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP018449
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP018449
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: