Healthcare Provider Details

I. General information

NPI: 1669319166
Provider Name (Legal Business Name): MEGAN N BUCKNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 BLUE ASH RD
CINCINNATI OH
45236-3660
US

IV. Provider business mailing address

6375 FIELDSTEADE DR
INDEPENDENCE KY
41051-8326
US

V. Phone/Fax

Practice location:
  • Phone: 513-975-0377
  • Fax:
Mailing address:
  • Phone: 859-609-1426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: