Individual
TIMOTHY D BUYESKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2424 S 90TH ST FL 3, WEST ALLIS, WI 53227-2455
(414) 649-1280
Mailing address
2424 S 90TH ST FL 3, WEST ALLIS, WI 53227-2455
(414) 649-1280
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28242220A
IN
363L00000X
Nurse Practitioner
Primary
14037-033
WI
363LA2100X
Acute Care Nurse Practitioner
71013052A
IN
363LG0600X
Gerontology Nurse Practitioner
71013052A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100245231
—
WI
Enumeration date
08/22/2022
Last updated
10/06/2023
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