Individual
NICOLE BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19 DOGWOOD DR, ROMNEY, WV 26757-8006
(304) 671-6805
Mailing address
19 DOGWOOD DR, ROMNEY, WV 26757-8006
(304) 671-6805
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002086739
VA
164W00000X
Licensed Practical Nurse
32586
WV
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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