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General NPI Number Information
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NPI Number | 1265099303
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Entity Type | Individual
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Provider Name | SARAH EMILY BUCKNER RN, AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 1400 US HIGHWAY 61 STE G50
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City | FESTUS
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State | MO
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Zip | 63028-4142
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Country | US
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Telephone | 314-366-4874
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 MAYWOOD DR
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City | EUREKA
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State | MO
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Zip | 63025-2766
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Country | US
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Telephone | 636-236-6958
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2009023414
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP140436
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2018034003
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License Number State | MO
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