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Organization
WELLCARE FAMILY MEDICINE PLLC
Active
Organization
WELLCARE FAMILY MEDICINE PLLC
Active
Other names
Angela Buckner
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA LOUISE BUCKNER APN (OWNER/PROVIDER)
(423) 949-9355
Entity
Organization
Contact information
Practice address
517 RUSSELL ST, SUITE C, DUNLAP, TN 37327-3648
(423) 949-9355
(423) 949-9358
Mailing address
517 RUSSELL ST, SUITE C, DUNLAP, TN 37327-3648
(423) 949-9355
(423) 949-9358
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN16901
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529434
—
TN
Enumeration date
04/11/2017
Last updated
04/11/2017
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