Individual
MRS. LISA M BUCKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
205 ORCHARD DR, SISSETON, SD 57262-2312
(605) 698-7681
(605) 698-3493
Mailing address
205 ORCHARD DR, SISSETON, SD 57262-2312
(605) 698-7681
(605) 698-3493
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R-158898-7
MN
363L00000X
Nurse Practitioner
Primary
R022487
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630958500
—
MN
05
—
6823133
—
SD
Enumeration date
06/27/2005
Last updated
07/08/2007
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