Individual
JERI BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, ARNP, FNP-BC
Contact information
Practice address
17120 KERCHEVAL AVE, GROSSE POINTE, MI 48230-1661
(313) 886-3300
(313) 417-1071
Mailing address
17120 KERCHEVAL AVE, GROSSE POINTE, MI 48230-1661
(313) 886-3300
(313) 417-1071
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9301335
FL
363LF0000X
Family Nurse Practitioner
Primary
4704243688
MI
363LF0000X
Family Nurse Practitioner
ARNP9301335
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015518900
—
FL
01
—
Y0S9X
BCBS
FL
Enumeration date
07/01/2015
Last updated
03/17/2018
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