Provider Demographics
NPI:1730318320
Name:BUCK, ANGELA R (FNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:BUCK
Suffix:
Gender:F
Credentials:FNP
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 22
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04740-0022
Mailing Address - Country:US
Mailing Address - Phone:207-488-7027
Mailing Address - Fax:207-488-7029
Practice Address - Street 1:80 CENTER RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:ME
Practice Address - Zip Code:04740-4337
Practice Address - Country:US
Practice Address - Phone:207-488-7027
Practice Address - Fax:207-488-7029
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP091029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily