Doctor Name: | KRISTI BUIS |
NPI Number: | 1205088283 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 71002657A |
Business Practice Address: | 1920 Churchman Ave Apt A Beech Grove, IN - 461071000 |
Business Phone Number: | 3178591090 |
Business Fax Number: | 3178593322 |
Mailing Address: | Po Box 100, BEECH GROVE |
State: | IN |
Postal Code: | 461070100 |
Phone Number: | 3178591090 |
Fax Number: | 3178593322 |
NPI Enumeration Date: | 10/21/2008 |
NPI Last Update Date: | 03/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71002657A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |