Individual
LAURA LEA BUCKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSRN, PHN
Contact information
Practice address
2191 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4534
(805) 788-2188
Mailing address
981 LAS TUNAS ST, MORRO BAY, CA 93442-2319
(805) 903-3771
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
492283
CA
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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