| Laura Bucknell, | |
|
1604 W 18th St, Portales, NM 88130-7097 | |
| (575) 359-4719 | |
| Not Available |
| Full Name | Laura Bucknell |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 1604 W 18th St, Portales, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457880296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 5186 (New Mexico) | Primary |
| Provider Name | Eastern New Mexico University |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1356115273 PECOS PAC ID: 1153766753 Enrollment ID: O20240305000546 |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Bucknell, 1500 S Avenue K, Portales, NM 88130-7400 Ph: () - | Laura Bucknell, 1604 W 18th St, Portales, NM 88130-7097 Ph: (575) 359-4719 |
Ciara Foust, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 501 S Abilene Ave, Portales, NM 88130 Phone: 575-359-3707 | |
Ms. Melissa Diane Pacheco, M.S., SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 501 S Abilene Ave, Portales, NM 88130 Phone: 505-359-3707 | |
James William Lovell, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1500 S Avenue K, Portales, NM 88130 Phone: 575-562-4232 | |
Erin Standefer, MSCCCSLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1225 Libra Dr, Portales, NM 88130 Phone: 575-309-3434 | |
Mrs. Tiffany Marie Huizenga, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 501 S Abilene, Portales, NM 88130 Phone: 505-359-3707 Fax: 505-356-6682 | |
Taylor Rae Crabtree, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1500 S Ave K, Station 3, Shroc, Portales, NM 88130 Phone: 575-562-2160 | |
Ms. Deanna Mari Cordova, MS CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1517 S Main Ave, Portales, NM 88130 Phone: 575-749-2711 |