Individual
THERESA S BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
207 KING OLAF CT, COLFAX, WI 54730-9517
(715) 962-2285
(715) 962-2285
Mailing address
207 KING OLAF COURT, COLFAX, WI 54730
(715) 962-2285
(715) 962-2285
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2306
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41175800
—
WI
Enumeration date
01/16/2006
Last updated
07/28/2009
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