Doctor Name: | AMANDA BUKSA |
NPI Number: | 1326419268 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | COA. 18296-NP |
Business Practice Address: | 2180 Parmalee Dr Seven Hills, OH - 441314116 |
Business Phone Number: | 4405705556 |
Business Fax Number: | |
Mailing Address: | 2180 Parmalee Dr, SEVEN HILLS |
State: | OH |
Postal Code: | 441314116 |
Phone Number: | 4405705556 |
Fax Number: | |
NPI Enumeration Date: | 10/19/2015 |
NPI Last Update Date: | 10/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | COA. 18296-NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |