Individual
MRS. ANGELA J BUCKALEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(888) 226-4343
Mailing address
262 DANNY THOMAS PL # MS 515, MEMPHIS, TN 38105-3678
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN144026
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 12788
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03787223
—
MS
05
—
186249001
—
AR
05
—
3600076
—
TN
01
—
4157558
BCBSTN
TN
01
—
84586
BLUE CROSS
AR
Enumeration date
05/01/2007
Last updated
10/27/2020
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