Provider Demographics
NPI:1851372635
Name:BUCK, MARJORIE HELEN (RNCS)
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:HELEN
Last Name:BUCK
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Gender:F
Credentials:RNCS
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Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:BOX 200
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2745
Practice Address - Country:US
Practice Address - Phone:505-272-4763
Practice Address - Fax:505-272-0690
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2014-05-19
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Provider Licenses
StateLicense IDTaxonomies
NMR10817163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMVNM00721Medicaid