Provider Demographics
NPI:1508437203
Name:BUEHRER, TESSA MARIE
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:MARIE
Last Name:BUEHRER
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 1:603 S NORRIS ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50228-8516
Mailing Address - Country:US
Mailing Address - Phone:515-249-5209
Mailing Address - Fax:
Practice Address - Street 1:3625 N ANKENY BLVD STE A
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4611
Practice Address - Country:US
Practice Address - Phone:515-965-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-05
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125154183500000X
IA24333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist