Individual
LAUREN ANNA BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 RIVERSIDE AVE, PEDS EDUCATION OFFICE 1ST FLOOR EAST BUILDING 8950A, MINNEAPOLIS, MN 55454-1450
(612) 624-4477
Mailing address
2450 RIVERSIDE AVE, AO-102, DELIVERY CODE 8951, MINNEAPOLIS, MN 55454-1450
(612) 624-3113
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
65195
MN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/18/2016
Last updated
08/10/2022
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