Individual
ALTHEA M BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7975 LAKE UNDERHILL RD STE 220B, ORLANDO, FL 32822-8202
(407) 303-6772
(407) 303-6775
Mailing address
501 SE OSCEOLA ST, STE 301, STUART, FL 34994-2347
(772) 223-5955
(772) 223-5954
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP 9192140
FL
363LF0000X
Family Nurse Practitioner
Primary
ARNP9192140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013940000
—
FL
Enumeration date
06/10/2010
Last updated
04/04/2019
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