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NPI Code Detail

MEDICARE: SHELBY LAUREN BUCCERI CNS

MEDICARE: SHELBY LAUREN BUCCERI CNS
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
1364SG0600XGerontology Clinical Nurse Specialist0019524OH

General Provider Information

NPI Number : 1801758461
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY LAUREN BUCCERI CNS
Provider Business Mailing Address
First Line : 7920 PEDDLER CIR NE
Second Line :
City : CANTON
State : OH
Zip : 44721-2369
Country : US
Telephone Number : 330-689-8348
Fax Number :
Provider Business Practice Location Address
First Line : 1320 MERCY DR NW
Second Line :
City : CANTON
State : OH
Zip : 44708-2614
Country : US
Telephone Number : 330-489-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ SHELBY LAUREN BUCCERI CNS” Practice Location

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