Individual
CHARLAE E BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1017 HUNTSWORTH CT, CAPITOL HEIGHTS, MD 20743-3044
(301) 404-3393
Mailing address
1017 HUNTSWORTH CT, CAPITOL HEIGHTS, MD 20743-3044
(301) 404-3393
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B256115234830
—
MD
Enumeration date
04/27/2020
Last updated
04/27/2020
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