Individual
MITZI BUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1125 W HIGHWAY 30, GONZALES, LA 70737-5004
(337) 534-0952
Mailing address
1125 W HIGHWAY 30, GONZALES, LA 70737-5004
(337) 534-0952
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
230063
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017008672
MISSOURI NURSING LICENSE
—
Enumeration date
11/08/2017
Last updated
09/07/2023
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