Provider Demographics
NPI:1336180025
Name:BUIE, JAMES (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:BUIE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W 14TH STREET,
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130
Mailing Address - Country:US
Mailing Address - Phone:812-284-1700
Mailing Address - Fax:812-284-3822
Practice Address - Street 1:302 W 14TH STREET,
Practice Address - Street 2:SUITE 100B
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130
Practice Address - Country:US
Practice Address - Phone:812-284-1700
Practice Address - Fax:812-284-3822
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28056649A363L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN254570AMedicare PIN
INCB60100Medicare UPIN