Provider Demographics
NPI:1811766256
Name:BUCKLEY, ELIZABETH ATKISON (CD-L)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ATKISON
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:CD-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4337 WATER OAK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2081
Mailing Address - Country:US
Mailing Address - Phone:302-598-6351
Mailing Address - Fax:
Practice Address - Street 1:4337 WATER OAK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2081
Practice Address - Country:US
Practice Address - Phone:302-598-6351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula