Provider Demographics
NPI:1285929893
Name:BUYSSE, KATHRYN LYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LYN
Last Name:BUYSSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 COUNTY ROAD 42 W
Mailing Address - Street 2:TARGET T-2340
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4426
Mailing Address - Country:US
Mailing Address - Phone:952-236-3004
Mailing Address - Fax:952-236-3014
Practice Address - Street 1:810 COUNTY ROAD 42 W
Practice Address - Street 2:TARGET T-2340
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4426
Practice Address - Country:US
Practice Address - Phone:952-236-3004
Practice Address - Fax:952-236-3014
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist