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NPI 1235106485

NPI 1235106485 : NANCI JAYNE BUCY DO : LAKE ST. LOUIS, MO

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General NPI Number Information
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    NPI Number           |    1235106485
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    Entity Type          |    Individual 
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    Provider Name        |    NANCI JAYNE BUCY DO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/07/2006
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    Last Update Date     |    02/25/2020
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Provider Practice Location Address
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    Address Line         |    1000 EDGEWATER POINTE SUITE 200
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    City                 |    LAKE ST. LOUIS
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    State                |    MO
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    Zip                  |    63367
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    Country              |    US
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    Telephone            |    636-561-8088
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    Fax                  |    636-561-1405
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Provider Business Mailing Address
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    Address Line         |    1000 EDGEWATER POINTE, STE: 200 
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    City                 |    LAKE ST. LOUIS
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    State                |    MO
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    Zip                  |    63367
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    Country              |    US
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    Telephone            |    636-561-8088
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    Fax                  |    636-561-1405
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    R6N47
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    License Number State |    MO
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