Individual
JACQUELYN BUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
425 E 1ST ST, BLOOMSBURG, PA 17815-1480
(570) 416-1890
(570) 416-1892
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP015193
PA
363LP2300X
Primary Care Nurse Practitioner
SP015193
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
467939
MEDICARE
PA
Enumeration date
11/29/2015
Last updated
08/30/2020
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