Stacie D Buckley, | |
1067 Peachtree St, Louisville, GA 30434-1599 | |
(478) 625-7000 | |
Not Available |
Full Name | Stacie D Buckley |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 1067 Peachtree St, Louisville, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265297873 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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363LF0000X | Nurse Practitioner - Family | RN140629 (Georgia) | Primary |
Entity Name | Southland Emergency Medical Services Consolidated, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033464391 PECOS PAC ID: 4183871320 Enrollment ID: O20120823000503 |
Mailing Address | Practice Location Address |
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Stacie D Buckley, 1067 Peachtree St, Louisville, GA 30434-1558 Ph: () - | Stacie D Buckley, 1067 Peachtree St, Louisville, GA 30434-1599 Ph: (478) 625-7000 |
Mrs. Erin Grace Nobles, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1067 Peachtree St, Louisville, GA 30434 Phone: 478-625-8471 Fax: 478-625-8477 | |
Phillip Zachary Perkins, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1067 Peachtree St, Louisville, GA 30434 Phone: 478-625-8471 | |
Mrs. Amy Bedingfield, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1067 Peachtree St, Louisville, GA 30434 Phone: 478-625-7000 Fax: 478-625-8907 |