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General NPI Number Information
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NPI Number | 1821591991
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Entity Type | Individual
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Provider Name | ALICIA ROBERTA BUECHE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 201 S WILLIAM ST
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City | SOUTH BEND
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State | IN
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Zip | 46601-2515
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Country | US
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Telephone | 574-234-2870
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Fax |
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Provider Business Mailing Address
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Address Line | 5639 E 350 N
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City | ROLLING PRAIRIE
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State | IN
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Zip | 46371-9594
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Country | US
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Telephone | 574-520-8368
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28207642A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71008073A
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License Number State | IN
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