Individual
JANET CHERYL BUCANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 471-1866
(808) 471-1855
Mailing address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 471-1866
(808) 471-1855
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2321281111
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2321281111
LICENSED PRACTICAL NURSE
KS
Enumeration date
08/06/2007
Last updated
08/07/2007
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