Jalicia Buckholts, is a
Registered Nurse based in Vienna, Georgia. Jalicia Buckholts is licensed to practice in Georgia (license number 310515) and her current practice location is
511 Clover St, Vienna, Georgia. She can be reached at her office (for appointments etc.) via phone at
(229) 815-1325.
NPI number for Jalicia Buckholts is 1528790326 and her current mailing address is 511 Clover St, Vienna, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1528790326.
Provider's Profile
| Full Name | Jalicia Buckholts |
|---|
| Gender | Female |
|---|
| Speciality | Registered Nurse |
|---|
| Location | 511 Clover St, Vienna, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1528790326
- Provider Enumeration Date: 06/29/2022
- Last Update Date: 06/29/2022
Medical Identifiers
Medical identifiers for Jalicia Buckholts such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528790326 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 310515 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jalicia Buckholts is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jalicia Buckholts,
511 Clover St,
Vienna, GA 31092-0904
Ph: (229) 815-1325 | Jalicia Buckholts,
511 Clover St,
Vienna, GA 31092-0904
Ph: (229) 815-1325 |
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