Provider Demographics
NPI:1093422628
Name:BUCEY, KEARA MARIE (PA)
Entity Type:Individual
Prefix:
First Name:KEARA
Middle Name:MARIE
Last Name:BUCEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:787 SE SAINT LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-1324
Mailing Address - Country:US
Mailing Address - Phone:832-816-1856
Mailing Address - Fax:
Practice Address - Street 1:787 SE SAINT LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-1324
Practice Address - Country:US
Practice Address - Phone:832-816-1856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant