Healthcare Provider Details

I. General information

NPI: 1891628624
Provider Name (Legal Business Name): ERICA FAITH BUCKLER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MITCHELLVILLE RD STE A414
BOWIE MD
20716-3142
US

IV. Provider business mailing address

39458 THOMAS DR
MECHANICSVILLE MD
20659-3625
US

V. Phone/Fax

Practice location:
  • Phone: 301-249-8100
  • Fax:
Mailing address:
  • Phone: 301-249-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR187543
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: