Doctor Name: | KIILANI BUCZKOWSKI |
NPI Number: | 1265861041 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | AP5242 |
Business Practice Address: | 483 W Seedfarm Rd Sacaton, AZ - 85147 |
Business Phone Number: | 6025281215 |
Business Fax Number: | |
Mailing Address: | Po Box 47624, PHOENIX |
State: | AZ |
Postal Code: | 850687624 |
Phone Number: | 6023698742 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2013 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP5242 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |