Provider Demographics
NPI:1982924072
Name:BUXMAN, LISA RAE (CPM RM)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:RAE
Last Name:BUXMAN
Suffix:
Gender:F
Credentials:CPM RM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 68TH AVE. #702
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634
Mailing Address - Country:US
Mailing Address - Phone:970-396-3822
Mailing Address - Fax:
Practice Address - Street 1:1900 68TH AVE UNIT 702
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-7971
Practice Address - Country:US
Practice Address - Phone:970-396-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO119176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife