Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 0024094164 | VA |
NPI | 1083635734 |
---|---|
Provider Name | Catherine A Buck |
First Address | Richmond, VA 23235-3800 |
Second Address | Richmond, VA 23249-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |