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General NPI Number Information
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NPI Number | 1093145682
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Entity Type | Organization
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Legal Business Name | KRISTIN BUSCHEMEYER, PA-C, PLLC
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Dates
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Enumeration Date | 11/18/2013
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Last Update Date | 11/18/2013
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Provider Practice Location Address
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Address Line | 418 WINGED FOOT DR
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City | LUFKIN
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State | TX
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Zip | 75901-7741
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Country | US
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Telephone | 203-641-5358
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Fax |
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Provider Business Mailing Address
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Address Line | 418 WINGED FOOT DR
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City | LUFKIN
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State | TX
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Zip | 75901-7741
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Country | US
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Telephone | 203-641-5358
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KRISTIN BUSCHEMEYER
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Credential | PA-C
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Telephone | 203-641-5358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA08078
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License Number State | TX
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