Provider Demographics
NPI:1821591991
Name:BUECHE, ALICIA ROBERTA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:ROBERTA
Last Name:BUECHE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5639 E 350 N
Mailing Address - Street 2:
Mailing Address - City:ROLLING PRAIRIE
Mailing Address - State:IN
Mailing Address - Zip Code:46371-9594
Mailing Address - Country:US
Mailing Address - Phone:574-520-8368
Mailing Address - Fax:
Practice Address - Street 1:201 S WILLIAM ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-2515
Practice Address - Country:US
Practice Address - Phone:574-234-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28207642A363LF0000X
IN71008073A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily