Provider Demographics
NPI:1326351107
Name:BUESCHER, HOLLY JO
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:JO
Last Name:BUESCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 4 AVENUE
Mailing Address - Street 2:
Mailing Address - City:BOVEY
Mailing Address - State:MN
Mailing Address - Zip Code:55709-0370
Mailing Address - Country:US
Mailing Address - Phone:218-259-9139
Mailing Address - Fax:
Practice Address - Street 1:309 4 AVENUE
Practice Address - Street 2:
Practice Address - City:BOVEY
Practice Address - State:MN
Practice Address - Zip Code:55709-0370
Practice Address - Country:US
Practice Address - Phone:218-259-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child