Provider Demographics
NPI:1104354513
Name:BUZZARD, BONNIE JEAN (LPN)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:JEAN
Last Name:BUZZARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 LANCASTER DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-1877
Mailing Address - Country:US
Mailing Address - Phone:785-727-8985
Mailing Address - Fax:
Practice Address - Street 1:2412 LANCASTER DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-1877
Practice Address - Country:US
Practice Address - Phone:785-727-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS37108164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse