Provider Demographics
NPI:1154677219
Name:BUHLER, JEANNIE A (NP)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:A
Last Name:BUHLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3264 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6068
Mailing Address - Country:US
Mailing Address - Phone:559-801-5788
Mailing Address - Fax:
Practice Address - Street 1:1105 E SPRUCE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3313
Practice Address - Country:US
Practice Address - Phone:559-432-5156
Practice Address - Fax:559-432-8812
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21995163WM0705X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical