Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 59353 | TN |
Y | 2080P0216X | Pediatric Rheumatologist | 59353 | TN |
NPI | 1497192223 |
---|---|
Provider Name | Lisa Hunt Buckley |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2013 |
Last Update Date | 15/10/2020 |