Individual
ALICE BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1435 CHERRY GROVE RD, CRYSTAL SPRINGS, MS 39059-8749
(601) 331-0617
Mailing address
PO BOX 877, TERRY, MS 39170-0877
(601) 331-0617
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
903834
MS
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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