Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | RN147013 | MO |
NPI | 1043490857 |
---|---|
Provider Name | Mrs. Julie Marie Buford |
First Address | Fredericktown, MO 63645-1111 |
Second Address | Fredericktown, MO 63645-1111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 22/08/2019 |