Individual
KATELYN MARCEL BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660
(423) 224-5550
Mailing address
240 CAIN DR, BLOUNTVILLE, TN 37617-4822
(423) 330-3014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24173
TN
Other
Enumeration date
05/24/2018
Last updated
09/28/2020
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