Provider Demographics
NPI:1104968221
Name:BUESING, ABIGAIL R (PA-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:R
Last Name:BUESING
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 1:709 W MAIN ST
Mailing Address - Street 2:P.O. BOX 359
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-0359
Mailing Address - Country:US
Mailing Address - Phone:563-927-7986
Mailing Address - Fax:563-927-7935
Practice Address - Street 1:111 EAST MISSION ST
Practice Address - Street 2:
Practice Address - City:STRAWBERRY POINT
Practice Address - State:IA
Practice Address - Zip Code:52076
Practice Address - Country:US
Practice Address - Phone:563-933-6277
Practice Address - Fax:563-933-6131
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001579363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAQ22765Medicaid
IAQ22765Medicaid