MEDICARE: KAYLA MARIE BUSKIRK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209034382	IL

General Provider Information

NPI Number	:	1760316756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA MARIE BUSKIRK

Provider Business Mailing Address
First Line	:	126 W MCCLURE AVE
Second Line	:
City	:	BARTONVILLE
State	:	IL
Zip	:	61607-2453
Country	:	US
Telephone Number	:	309-229-7024
Fax Number	:	309-229-7024

Provider Business Practice Location Address
First Line	:	9014 N WOOD SAGE RD
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61615-7908
Country	:	US
Telephone Number	:	844-360-8600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ KAYLA MARIE BUSKIRK ” Practice Location

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