Provider Demographics
NPI:1407513542
Name:BUCHANEN, MARGERY (RN)
Entity Type:Individual
Prefix:
First Name:MARGERY
Middle Name:
Last Name:BUCHANEN
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 1:6000 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANDY CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:13145-3190
Mailing Address - Country:US
Mailing Address - Phone:315-391-4959
Mailing Address - Fax:
Practice Address - Street 1:6000 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SANDY CREEK
Practice Address - State:NY
Practice Address - Zip Code:13145-3190
Practice Address - Country:US
Practice Address - Phone:315-391-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY829688163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse