Provider Demographics
NPI:1487078259
Name:BUEIDE, CHRISTINA (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:BUEIDE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 Q ST
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-2313
Mailing Address - Country:US
Mailing Address - Phone:308-672-5079
Mailing Address - Fax:
Practice Address - Street 1:2325 LODGE DR
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-6825
Practice Address - Country:US
Practice Address - Phone:308-436-5965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE242224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant