Individual
TIAIRA BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
549 FALLEN TIMBERS DR, ORANGE PARK, FL 32073-2298
(616) 666-7998
Mailing address
549 FALLEN TIMBERS DR, ORANGE PARK, FL 32073-2298
(616) 666-7998
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041453441
IL
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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