Provider Demographics
NPI:1427187806
Name:BUESING, AMY S (RPH)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:S
Last Name:BUESING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15395 S HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:NM
Mailing Address - Zip Code:88044-9410
Mailing Address - Country:US
Mailing Address - Phone:505-644-0854
Mailing Address - Fax:
Practice Address - Street 1:15395 S HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:NM
Practice Address - Zip Code:88044-9410
Practice Address - Country:US
Practice Address - Phone:505-644-0854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist