Provider Demographics
NPI:1568134849
Name:BUCZEK, MEGAN E (CHD)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:E
Last Name:BUCZEK
Suffix:
Gender:F
Credentials:CHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 CRIMSON WAY
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9069
Mailing Address - Country:US
Mailing Address - Phone:920-595-0029
Mailing Address - Fax:
Practice Address - Street 1:1940 CRIMSON WAY
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9069
Practice Address - Country:US
Practice Address - Phone:920-595-0029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula