Provider Demographics
NPI:1235725383
Name:BUFFINGTON, HOWARD KELLY (FNP-C)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:KELLY
Last Name:BUFFINGTON
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 REDMOND RD NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1416
Mailing Address - Country:US
Mailing Address - Phone:706-528-9060
Mailing Address - Fax:706-290-2399
Practice Address - Street 1:504 REDMOND RD NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1416
Practice Address - Country:US
Practice Address - Phone:706-528-9060
Practice Address - Fax:706-290-2399
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF09201666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily