Provider Demographics
NPI:1669430419
Name:BUCHNER, SUZANNE (NP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BUCHNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 COWDEN DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2146
Mailing Address - Country:US
Mailing Address - Phone:512-266-3771
Mailing Address - Fax:
Practice Address - Street 1:3521 COWDEN DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-2146
Practice Address - Country:US
Practice Address - Phone:512-266-3771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX704125363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ16136Medicare UPIN
TX8B8788Medicare ID - Type Unspecified