Individual
JEREMY BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
823 SW MULVANE ST, TOPEKA, KS 66606-1764
(785) 234-3451
Mailing address
626 N WREN DR, LAWRENCE, KS 66049-4694
(785) 760-0029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-117539-032
KS
163W00000X
Registered Nurse
2012001063
MO
163W00000X
Registered Nurse
77574
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
514428
KS
Other
Enumeration date
02/25/2017
Last updated
02/23/2026
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