Individual
CHRISTEN H BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5160
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 944-5160
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R880177
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03274801
—
MS
01
—
P01500389
RR MEDICARE PTAN
MS
Enumeration date
01/16/2013
Last updated
10/06/2015
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