Organization
BUCILLA HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PENNIE ELIZABETH BUCILLA APRN CNP (OWNER)
(952) 892-9393
Entity
Organization
Contact information
Practice address
1500 MCANDREWS RD W, BURNSVILLE MN, MN 55337
(952) 892-9393
(952) 892-9395
Mailing address
1500 MCANDREWS RD W, BURNSVILLE MN, MN 55337
(952) 892-9393
(952) 892-9395
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R156407-9
MN
Other
Enumeration date
05/02/2018
Last updated
09/22/2020
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