Individual
HEATHER R. BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
65 HOSPITAL DR, ATHENS, OH 45701
(740) 566-4890
(740) 566-4891
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.16859-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114811
—
OH
05
—
3810028474
—
WV
01
—
P01547265
RAILROAD MEDICARE MHCPI
OH
Enumeration date
07/03/2014
Last updated
09/14/2021
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