Individual
MS. ELLEN BUCKINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4005 GRANITE CREEK RD, SCOTTS VALLEY, CA 95066-3742
(831) 440-1320
Mailing address
4005 GRANITE CREEK RD, SCOTTS VALLEY, CA 95066-3742
(831) 440-1320
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN480995
CA
163WC0400X
Case Management Registered Nurse
480995
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RVN002450
—
CA
Enumeration date
01/19/2007
Last updated
07/03/2023
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