Buckner, Kaitlin

Buckner, Kaitlin is an individual health care provider with primary practice located at 6043 Hudson Rd Ste 220 , Woodbury MN 55125-1033. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Buckner, Kaitlin can be contacted via phone (651) 925-8200.

Contact Information

Primary practice address
6043 Hudson Rd Ste 220 Woodbury MN 55125-1033
Phone: (651) 925-8200
Fax: (651) 925-8201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 6669778-1206 Utah
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3127 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1414 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10495 Minnesota

Profile Details

NPI number 1104852094
LBN Legal business name Buckner, Kaitlin
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Oct 19th, 2018 - about 6 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 1104852094 NPPES
Oklahoma MEDICAID 20047220A

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