Individual
ETHEL BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1654 E UNION ST, GREENVILLE, MS 38703-3250
(662) 335-7146
(662) 335-3976
Mailing address
1654 E UNION ST, GREENVILLE, MS 38703-3250
(662) 335-7146
(662) 335-3976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
P143308
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018205
—
MS
Enumeration date
02/04/2008
Last updated
02/12/2008
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