Provider Demographics
NPI:1205145802
Name:BUFFUM, LISA MARIE (RN, MS, GNP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:BUFFUM
Suffix:
Gender:F
Credentials:RN, MS, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1601 YGNACIO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3122
Mailing Address - Country:US
Mailing Address - Phone:925-941-4182
Mailing Address - Fax:925-941-4203
Practice Address - Street 1:1601 YGNACIO VALLEY RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3122
Practice Address - Country:US
Practice Address - Phone:925-941-4182
Practice Address - Fax:925-941-4203
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20058363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology