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General NPI Number Information
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NPI Number | 1386366649
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Entity Type | Organization
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Legal Business Name | FIRST STEPS WELLNESS LLC
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 252 N MAIN ST STE 1
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City | RUSSELLVILLE
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State | KY
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Zip | 42276-1825
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Country | US
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Telephone | 270-216-0864
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Fax | 270-596-0002
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Provider Business Mailing Address
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Address Line | 252 N MAIN ST STE 1
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City | RUSSELLVILLE
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State | KY
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Zip | 42276-1825
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Country | US
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Telephone | 270-216-0864
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. KIMBERLY CHEREE BUCKNER
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Credential | ARNP
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Telephone | 270-306-1008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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