Individual
JEANETTE BUCKHALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8213 ANTERO PL, EL PASO, TX 79904-2401
(915) 226-6531
Mailing address
8213 ANTERO PL, EL PASO, TX 79904-2401
(915) 226-6531
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
561294
TX
Other
Enumeration date
10/15/2011
Last updated
10/15/2011
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