Provider Demographics
NPI:1629341847
Name:BUSCHMANN, REBECCA DOROTHY (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DOROTHY
Last Name:BUSCHMANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 W BOLIVAR AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-4947
Mailing Address - Country:US
Mailing Address - Phone:414-763-7956
Mailing Address - Fax:
Practice Address - Street 1:3546 W HENRY AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-4637
Practice Address - Country:US
Practice Address - Phone:414-421-6547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-18
Last Update Date:2012-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI186550-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health