MISS ANGLE RENEE BUCKLES FNP NPI 1417192741

NPI Information

NPI: 1417192741
Provider Name: MISS ANGLE RENEE BUCKLES, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
2514 WESLEY ST STE 102
JOHNSON CITY, TN
ZIP 37601
Phone: (423) 631-0236
Get Directions

MISS Angle Renee Buckles, FNP is a family nurse practitioner in Johnson City, TN. MISS Angle Renee Buckles, FNP NPI is 1417192741. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2514 WESLEY ST STE 102
JOHNSON CITY, TN
ZIP 37601-764
Phone: (423) 631-0236
Fax: (423) 631-0237

The enumeration date for this NPI number is 12/16/2008 and was last updated on 5/16/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	APRN0000014399	TENNESSEE	No
2	363L00000X	Nurse Practitioner		APRN0000014399	TENNESSEE	No
3	363LF0000X	Nurse Practitioner	Family	APRN0000014399	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4243703	OTHER	TENNESSEE	BLUECROSS BLUESHIELD
2	103I502850	MEDICARE PIN	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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