Individual
NANCY A. BUCKHEISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADULT ACUTE CARE NP
Contact information
Practice address
10404 TUCKER RD, OCEAN SPRINGS, MS 39565-7922
(228) 354-9505
Mailing address
PO BOX 6190, DIBERVILLE, MS 39540-6190
(228) 354-9505
(228) 354-9575
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R852727
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03630279
—
MS
Enumeration date
01/31/2008
Last updated
05/02/2022
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