Provider Demographics
NPI:1013654789
Name:BUKOWSKI, HANNAH BARTEE (CRNM)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:BARTEE
Last Name:BUKOWSKI
Suffix:
Gender:F
Credentials:CRNM
Other - Prefix:MS
Other - First Name:HANNAH
Other - Middle Name:STARNES
Other - Last Name:BARTEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1978
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-1978
Mailing Address - Country:US
Mailing Address - Phone:410-749-1015
Mailing Address - Fax:410-749-0654
Practice Address - Street 1:3521 SILVERSIDE RD STE 2L1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4900
Practice Address - Country:US
Practice Address - Phone:302-477-1375
Practice Address - Fax:302-477-1383
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0072460163W00000X
MDR255027367A00000X
DELK-0010226367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid