Provider Demographics
NPI:1518382654
Name:BUZZARD, MARIA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BUZZARD
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 S DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-2104
Mailing Address - Country:US
Mailing Address - Phone:937-673-0773
Mailing Address - Fax:
Practice Address - Street 1:4100 S DIXIE DR
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-2104
Practice Address - Country:US
Practice Address - Phone:937-673-0773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN301270163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse