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General NPI Number Information
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NPI Number | 1023930484
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Entity Type | Individual
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Provider Name | LETICIA BUSWELL NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 307 MAIN ST
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City | CANON CITY
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State | CO
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Zip | 81212-3731
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Country | US
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Telephone | 719-457-6537
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Fax |
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Provider Business Mailing Address
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Address Line | 55 TANNER PKWY
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City | CANON CITY
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State | CO
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Zip | 81212-9418
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Country | US
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Telephone | 970-218-1606
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.1002215-NP
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License Number State | CO
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