Provider Demographics
NPI:1871028266
Name:LISA BUXMAN HOME MIDWIFERY CARE LLC
Entity Type:Organization
Organization Name:LISA BUXMAN HOME MIDWIFERY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUXMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPM RM
Authorized Official - Phone:970-396-3822
Mailing Address - Street 1:1711 35TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2812
Mailing Address - Country:US
Mailing Address - Phone:970-396-3822
Mailing Address - Fax:970-427-5008
Practice Address - Street 1:1711 35TH AVENUE CT
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2812
Practice Address - Country:US
Practice Address - Phone:970-396-3822
Practice Address - Fax:970-427-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000119302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization