Buckley, Brandie D

Buckley, Brandie D is an individual health care provider with primary practice located at 1314 19Th Ave , Meridian MS 39301-4116. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Buckley, Brandie D can be contacted via phone (601) 703-4415.

Contact Information

Primary practice address
1314 19Th Ave Meridian MS 39301-4116
Phone: (601) 703-4415
Fax: (601) 703-4418
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R858613 Mississippi

Profile Details

NPI number 1518178839
LBN Legal business name Buckley, Brandie D
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2007
Last updated Nov 9th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518178839 NPPES
Mississippi MEDICAID 08002873

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