Healthcare Provider Details

I. General information

NPI: 1881925899
Provider Name (Legal Business Name): BUFFIE BLUDWORTH BUCHANAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL HEIGHTS DR
MORGANTON NC
28655-5197
US

IV. Provider business mailing address

100 MEDICAL HEIGHTS DR
MORGANTON NC
28655-5197
US

V. Phone/Fax

Practice location:
  • Phone: 828-433-4484
  • Fax:
Mailing address:
  • Phone: 828-433-4484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5004552
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: