Provider Demographics
NPI:1124356811
Name:BUCKMAN, BRIGID M (ARNP)
Entity Type:Individual
Prefix:
First Name:BRIGID
Middle Name:M
Last Name:BUCKMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2700 STANLEY GAULT PKWY
Mailing Address - Street 2:SUITE 129
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5132
Mailing Address - Country:US
Mailing Address - Phone:502-253-4917
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:2400 EASTPOINT PKWY
Practice Address - Street 2:SUITE 410
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4154
Practice Address - Country:US
Practice Address - Phone:502-253-6625
Practice Address - Fax:502-253-6629
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2020-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY208VP0014X208VP0014X
KY3006270363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner