| Doctor Name: | MRS. SHELLY RAE BUCH |
| NPI Number: | 1114106184 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 4704222854 |
| Business Practice Address: | 3144 Vanzile Rd Crandon, WI - 54520 |
| Business Phone Number: | 7154785180 |
| Business Fax Number: | 7154785904 |
| Mailing Address: | 3144 Vanzile Rd, CRANDON |
| State: | WI |
| Postal Code: | 54520 |
| Phone Number: | 7154785180 |
| Fax Number: | 7154785904 |
| NPI Enumeration Date: | 10/26/2007 |
| NPI Last Update Date: | 12/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704222854 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |