Provider Demographics
NPI:1740039353
Name:BUCKIUS, NANCY (BA)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BUCKIUS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:RAUCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30811 LAKE LOGAN RD
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-9546
Mailing Address - Country:US
Mailing Address - Phone:740-243-7434
Mailing Address - Fax:
Practice Address - Street 1:30811 LAKE LOGAN RD
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-9546
Practice Address - Country:US
Practice Address - Phone:740-513-3078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program