Basic Information
| Provider Information | |||||||||
| NPI: | 1568829513 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUISSON | ||||||||
| FirstName: | LYNSEY | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN, RNFA, CNOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 938 | ||||||||
| Address2: | |||||||||
| City: | ROWLETT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142272457 | ||||||||
| FaxNumber: | 2147640880 | ||||||||
| Practice Location | |||||||||
| Address1: | 3042 HILL CT | ||||||||
| Address2: | |||||||||
| City: | MANDEVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704488488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042321103 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2016 | ||||||||
| LastUpdateDate: | 04/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WR0006X | RN116194 | LA | Y | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant | 163WR0006X | 008162874 | LA | N | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant |
No ID Information.