Individual
ANNA JO BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
11729 ROE AVE, LEAWOOD, KS 66211-2605
(866) 389-2727
Mailing address
11729 ROE AVE, LEAWOOD, KS 66211-2605
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-75469
KS
363LF0000X
Family Nurse Practitioner
2012000257
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002143
MEDICARE PTAN
KS
Enumeration date
09/08/2011
Last updated
01/09/2014
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