Provider Demographics
NPI:1275737728
Name:BUCKLE, ROBIN LEE (RN, CPNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:BUCKLE
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:BUCKLE-LEBOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CPNP
Mailing Address - Street 1:7720 N FRESNO ST
Mailing Address - Street 2:#104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2407
Mailing Address - Country:US
Mailing Address - Phone:559-438-1802
Mailing Address - Fax:559-438-1531
Practice Address - Street 1:7720 N FRESNO ST
Practice Address - Street 2:#104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2407
Practice Address - Country:US
Practice Address - Phone:559-438-1802
Practice Address - Fax:559-438-1531
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA268646363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics