Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP3480 | AZ |
N | 363LP0222X | Nurse Practitioner Pediatrics (Critical Care) | RN128885/AP3480 | AZ |
NPI | 1043547953 |
---|---|
Provider Name | Aimee Susanne Bucci |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2009 |
Last Update Date | 04/10/2019 |