Healthcare Provider Details

I. General information

NPI: 1518955723
Provider Name (Legal Business Name): DANA K BUECHNER FNP BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 09/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 WELCH CSWY
MADEIRA BEACH FL
33708-2814
US

IV. Provider business mailing address

6140 SUN BLVD UNIT 8
SAINT PETERSBURG FL
33715-1105
US

V. Phone/Fax

Practice location:
  • Phone: 727-202-3456
  • Fax:
Mailing address:
  • Phone: 614-257-9006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9304413
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: