| Doctor Name: | LINDA BUCKINGHAM |
| NPI Number: | 1073872057 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | R22682 |
| Business Practice Address: | 1397 Weimer Rd Diabetes Management Program Taos, NM - 875716253 |
| Business Phone Number: | 5757373285 |
| Business Fax Number: | |
| Mailing Address: | 1397 Weimer Rd, Diabetes Management Program TAOS |
| State: | NM |
| Postal Code: | 875716253 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/10/2012 |
| NPI Last Update Date: | 05/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | R22682 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |