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Individual

MRS. SHELLY RAE BUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1010 OLIVE AVE, FLORENCE, WI 54121-0380
(715) 528-4775
(715) 528-5592
Mailing address
PO BOX 549, IRON MOUNTAIN, MI 49801-0549
(906) 774-1313

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1084
AK
363LF0000X
Family Nurse Practitioner
Primary
4575-033
WI
363LF0000X
Family Nurse Practitioner
4704222854
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP0063
AK
Enumeration date
10/26/2007
Last updated
12/18/2019
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