Provider Demographics
NPI:1881038461
Name:BUCK, AMY NANETTE (APRN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:NANETTE
Last Name:BUCK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 CLINCH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-2435
Mailing Address - Country:US
Mailing Address - Phone:865-331-9075
Mailing Address - Fax:865-374-2141
Practice Address - Street 1:1819 CLINCH AVE STE 110
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2435
Practice Address - Country:US
Practice Address - Phone:865-331-9075
Practice Address - Fax:865-374-2141
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily