Individual
CANDACE BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-2326
Mailing address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-2326
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN258377
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN258377
GEORGIA BOARD OF NURSING
GA
Enumeration date
10/29/2020
Last updated
02/24/2021
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