Individual
JANE BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 BROADWAY, NORTH HAVEN, CT 06473-2365
(203) 234-0365
(203) 234-0801
Mailing address
100 BROADWAY, NORTH HAVEN, CT 06473-2365
(203) 745-6202
(203) 234-0801
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
002431
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932350105
GROUP INDENIFIER
CT
01
—
2208919
CIGNA
—
01
—
298056
MHN
—
01
—
400002431CT02
ANTHEM
CT
01
—
454047
VALUE OPTIONS
—
01
—
P2528334
OXFORD
—
Enumeration date
04/25/2006
Last updated
11/24/2015
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