Individual
JENNIFER JO BUCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01041552
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083034
ANTHEM NUMBER
IN
05
—
200127450A
—
IN
Enumeration date
07/07/2005
Last updated
08/02/2018
Update your record
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