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General NPI Number Information
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NPI Number | 1760365928
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Entity Type | Individual
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Provider Name | AVERY CATHRYN BUCK BA
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 400 FOGELMAN DRIVE #126
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City | MEMPHIS
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State | TN
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Zip | 38152-0001
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Country | US
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Telephone | 901-678-2147
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Fax |
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Provider Business Mailing Address
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Address Line | 6785 HUNTERS OAK DR APT 103
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City | MEMPHIS
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State | TN
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Zip | 38120-4487
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Country | US
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Telephone | 765-717-5992
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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