Individual
KIMBERLY CHEREE BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
252 N MAIN ST, RUSSELLVILLE, KY 42276-1825
(270) 216-0864
Mailing address
252 N MAIN ST, RUSSELLVILLE, KY 42276-1825
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1054570
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3016537
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6161072
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
86469
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
G173499
IA
Other
Enumeration date
08/17/2021
Last updated
01/23/2026
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