Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 1-141653 | AL |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 1-141653 | AL |
NPI | 1013420116 |
---|---|
Provider Name | Emily Loyd Buckner |
First Address | Dallas, TX 75202-2703 |
Second Address | Birmingham, AL 35243-2382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2017 |
Last Update Date | 05/12/2018 |