Provider Demographics
NPI:1891005633
Name:BUCHANAN, KATHLEEN LOY (NP-C)
Entity Type:Individual
Prefix:MISS
First Name:KATHLEEN
Middle Name:LOY
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 VALLEY VIEW LN, DALLAS, TX 75244
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244
Mailing Address - Country:US
Mailing Address - Phone:855-984-5121
Mailing Address - Fax:928-282-0007
Practice Address - Street 1:1890 W STATE ROUTE 89A STE D
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5571
Practice Address - Country:US
Practice Address - Phone:928-282-0005
Practice Address - Fax:928-282-0007
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily