1760892509 NPI number — DR. ELIZABETH BUYSE KESSLER D.C.

Table of content: DR. ELIZABETH BUYSE KESSLER D.C. (NPI 1760892509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760892509 NPI number — DR. ELIZABETH BUYSE KESSLER D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KESSLER
Provider First Name:
ELIZABETH
Provider Middle Name:
BUYSE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUYSE
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
CHRISTINE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760892509
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8900 109TH AVE N
Provider Second Line Business Mailing Address:
SUITE #700
Provider Business Mailing Address City Name:
CHAMPLIN
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55316-3164
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-807-6817
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8900 109TH AVE N
Provider Second Line Business Practice Location Address:
SUITE 700
Provider Business Practice Location Address City Name:
CHAMPLIN
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55316-3164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-807-6817
Provider Business Practice Location Address Fax Number:
763-390-6639
Provider Enumeration Date:
05/01/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  5920 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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