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Individual

JORETTA A BUCKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
200 TRILITH PKWY STE 100, FAYETTEVILLE, GA 30214-4462
(404) 948-3019
Mailing address
480 GLYNN ST N, FAYETTEVILLE, GA 30214-1192
(770) 461-3431

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN101831
GA

Other

Enumeration date
07/13/2006
Last updated
07/19/2022
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