Healthcare Provider Details

I. General information

NPI: 1275737728
Provider Name (Legal Business Name): ROBIN LEE BUCKLE R.N., C.P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN BUCKLE-LEBOW R.N., C.P.N.P.

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 N FRESNO ST #104
FRESNO CA
93720-2407
US

IV. Provider business mailing address

7720 N FRESNO ST #104
FRESNO CA
93720-2407
US

V. Phone/Fax

Practice location:
  • Phone: 559-438-1802
  • Fax: 559-438-1531
Mailing address:
  • Phone: 559-438-1802
  • Fax: 559-438-1531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number268646
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: