Individual
MRS. CRYSTAL ROSE BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
45 MARKETPLACE DR, SUITE 102, ROCKY MOUNT, VA 24151-6516
(540) 483-3678
(540) 483-3820
Mailing address
550 N FRANKLIN ST, CHRISTIANSBURG, VA 24073-1916
(434) 390-7224
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024171113
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05545
MEDICARE GROUP PTAN
VA
Enumeration date
08/16/2013
Last updated
10/20/2016
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