Individual
MARISSA BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2900 S TELEPHONE RD, SUITE 250, MOORE, OK 73160-2968
(405) 237-7500
Mailing address
10528 APPLEGROVE CIR, MIDWEST CITY, OK 73130-7060
(405) 237-7500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
99136
OK
Other
Enumeration date
01/28/2015
Last updated
04/20/2017
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