Provider Demographics
NPI:1346331899
Name:BUCHANAN, EILEEN C (RN)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:C
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:RN
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 889
Mailing Address - Street 2:
Mailing Address - City:DATIL
Mailing Address - State:NM
Mailing Address - Zip Code:87821-0889
Mailing Address - Country:US
Mailing Address - Phone:505-772-4765
Mailing Address - Fax:
Practice Address - Street 1:1 FOSTER LANE
Practice Address - Street 2:
Practice Address - City:RESERVE
Practice Address - State:NM
Practice Address - Zip Code:87830
Practice Address - Country:US
Practice Address - Phone:505-533-6456
Practice Address - Fax:505-533-6767
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR43468163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse