Provider Demographics
NPI:1235978313
Name:BUSHONG, KYRA ANN
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:ANN
Last Name:BUSHONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 W LIMA ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3134
Mailing Address - Country:US
Mailing Address - Phone:419-348-5052
Mailing Address - Fax:
Practice Address - Street 1:15054 STATE ROUTE 224 E
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-9794
Practice Address - Country:US
Practice Address - Phone:419-427-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program