Individual
MRS. JESSICA BLOOM BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304
(304) 388-4077
(304) 388-9852
Mailing address
3 DAWN PLACE, CHARLESTON, WV 25314
(304) 344-0949
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
61450
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
73554
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004241
—
WV
01
—
P00274757
R MEDICARE
WV
Enumeration date
10/24/2006
Last updated
09/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us