Individual
JORDAN REBECCA BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
767 MIHALSKI LN, SAINT HEDWIG, TX 78152-3638
(210) 902-7115
Mailing address
PO BOX 285, SAINT HEDWIG, TX 78152-0285
(210) 902-7115
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
353576
TX
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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