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NPI Code Detail

MEDICARE: STEVEN PERRY BUCKLAND LPN

MEDICARE: STEVEN PERRY BUCKLAND LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLPN.146186.MEDS-IVOH

General Provider Information

NPI Number : 1386158194
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN PERRY BUCKLAND LPN
Provider Business Mailing Address
First Line : 939 DAWN CT APT 1
Second Line :
City : MEDINA
State : OH
Zip : 44256-1354
Country : US
Telephone Number : 330-635-7580
Fax Number :
Provider Business Practice Location Address
First Line : 2301 SCRANTON RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-4311
Country : US
Telephone Number : 216-273-6998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2017
Last Update Date : 12/01/2017

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