Individual
PROF. LORI BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN
Contact information
Practice address
1901 WEST ST UNIT 204, ANNAPOLIS, MD 21401-3935
(410) 758-7779
Mailing address
1901 WEST ST UNIT 204, ANNAPOLIS, MD 21401-3935
(410) 758-7779
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
R185850
MD
163WC1400X
College Health Registered Nurse
Primary
R185850
MD
163WM0705X
Medical-Surgical Registered Nurse
R185850
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B240546501663
DRIVERS LICENSE
MD
Enumeration date
07/20/2020
Last updated
07/20/2020
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