Individual
GENEVIEVE THERESE BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
280 SIERRA COLLEGE DR STE 120, GRASS VALLEY, CA 95945-5763
(530) 477-4480
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
22688
CA
Other
Enumeration date
01/07/2013
Last updated
08/17/2017
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