Healthcare Provider Details

I. General information

NPI: 1447829072
Provider Name (Legal Business Name): CHELSEA ANN BUCHER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 E JACKSON BLVD
JACKSON MO
63755-2907
US

IV. Provider business mailing address

PO BOX 801143
KANSAS CITY MO
64180-1143
US

V. Phone/Fax

Practice location:
  • Phone: 573-243-3115
  • Fax: 573-243-4700
Mailing address:
  • Phone: 573-331-3000
  • Fax: 573-331-5073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021020998
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: