Individual
MS. MARLA DIANNE BUCKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
208 W CASABLANCA AVE, 27 MEDICAL GROUP BLDG 1400 CANNON AFB, CLOVIS, NM 88103-5009
(505) 784-6608
(505) 784-6028
Mailing address
208 W CASABLANCA AVE, 27 MEDICAL GROUP BLDG 1400 CANNON AFB, CLOVIS, NM 88101-5014
(505) 784-6605
(505) 784-6028
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
241753
TX
Other
Enumeration date
10/06/2005
Last updated
10/17/2007
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