Amy Buckanaga, RN
Individual provider Active NPI Registered Nurse · Cass Lake, MN
NPI 1053433573 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053433573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- R114300-5 (MN)
- Practice address
- 425 7TH St NW
Cass Lake, MN 56633-3360 - Phone
- (218) 335-3200
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R114300-5 | MN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R114300-5 | MN | Yes |
Addresses
Primary practice location
425 7TH St NW
Cass Lake, MN 56633-3360
Mailing address
425 7TH St NW
Cass Lake, MN 56633-3360
Phone (218) 335-3200
Other providers in Cass Lake, MN
- Karen J Black
- Diane Kay Bohn
- Rose Mone Brehon
- Rachel Lea Brist
- Josephine Evelyn Brown
- Dwayne Caneen
- Aaron Carter
- Terri Lynn Carter
- Cass Lake Indian Hospital
- Cass Lake Indian Hospital Pharmacy
All providers in Cass Lake, MN · Registered Nurse in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.