Individual
MICHELE K. BUCKREIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2000 E GREENVILLE ST, ANDERSON, SC 29621-1580
(864) 512-6697
Mailing address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1417
(864) 512-1823
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN 1555
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
750907019A
—
GA
01
—
771597
WELLCARE
SC
05
—
AN0918
—
SC
01
—
NPI #
BLUE CROSS
SC
01
—
P00736645
RAILROAD MEDICARE
SC
Enumeration date
04/11/2006
Last updated
09/23/2015
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