Individual
KIMBERLY BUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD., LP
Contact information
Practice address
14551 JUDICIAL RD STE 100, BURNSVILLE, MN 55306-4991
(952) 898-5020
(952) 898-5858
Mailing address
14551 JUDICIAL RD STE 100, BURNSVILLE, MN 55306-4991
(952) 898-5020
(952) 898-5858
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3946
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165935-00
AETNA
MN
01
—
167373
U CARE
MN
01
—
20206-02
PREFERREDONE BHP
MN
05
—
386981400
—
MN
01
—
39Q41BU
BCBS GROUP
MN
01
—
39Q42BU
BCBS INDIVIDUAL
MN
05
—
58501420
—
MN
01
—
61-77270
MEDICA UBH
MN
01
—
HP24334
HEALTHPARTNERS
MN
Enumeration date
11/06/2006
Last updated
04/05/2018
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