Provider Demographics
NPI:1922883909
Name:BUBENCHIK, LEXI BRYANNA (PA-C)
Entity Type:Individual
Prefix:
First Name:LEXI
Middle Name:BRYANNA
Last Name:BUBENCHIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-1162
Mailing Address - Country:US
Mailing Address - Phone:740-439-3515
Mailing Address - Fax:740-432-6427
Practice Address - Street 1:1515 MAPLE DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-1162
Practice Address - Country:US
Practice Address - Phone:740-439-3515
Practice Address - Fax:740-432-6427
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008341RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant