Provider Demographics
NPI:1114317419
Name:BUECHNER, DONNA (NPC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:BUECHNER
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53082-0959
Mailing Address - Country:US
Mailing Address - Phone:920-783-6633
Mailing Address - Fax:262-654-9333
Practice Address - Street 1:510 S 8TH ST
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4404
Practice Address - Country:US
Practice Address - Phone:920-783-6633
Practice Address - Fax:262-654-9333
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6194-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily