Individual
BRANDY BUCKHALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2603 KENTUCKY AVE, SUITE 105, PADUCAH, KY 42003-3814
(270) 443-4802
(270) 415-4835
Mailing address
2605 KENTUCKY AVE, SUITE 306, PADUCAH, KY 42003-3800
(270) 415-7653
(270) 575-8359
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3009074
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100352660
—
KY
Enumeration date
02/10/2015
Last updated
12/08/2020
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