Provider Demographics
NPI:1801005491
Name:BUCKELEW, CAROLYN PIERCE (RN APNC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN PIERCE
Middle Name:
Last Name:BUCKELEW
Suffix:
Gender:F
Credentials:RN APNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 HILLIARD RD
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1535
Mailing Address - Country:US
Mailing Address - Phone:732-251-6882
Mailing Address - Fax:
Practice Address - Street 1:79 HILLIARD RD
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1535
Practice Address - Country:US
Practice Address - Phone:732-251-6882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR03367900163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult