Josephine Buckley, RD
Individual provider Active NPI Registered Dietitian · Fenton, MO
NPI 1235909599 · NPPES record last updated Jan 8, 2024
Key facts
- NPI
- 1235909599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 2021035601 (MO)
- Practice address
- 320 Gravois Rd # 210-230
Fenton, MO 63026-4122 - Phone
- (636) 600-0446
- NPI assigned
- Jan 8, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021035601 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osage Valley Counseling LLC | Dietitian, Registered | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2021035601 | MO | Yes |
Addresses
Primary practice location
320 Gravois Rd # 210-230
Fenton, MO 63026-4122
Mailing address
8808 Sheryl Ann Dr
Saint Louis, MO 63126-2132
Phone (314) 580-6036
Other providers in Fenton, MO
- Lindsey N Bright
- Brookwood LLC
- Allison Kate Brown
- Kevin Eugene Bruce
- Kelsey Janet Brusati
- Susan J Budd
- Peggy Buechler
- Ashley Renee Buehler
- Gregory Buelt
- Shalee Buenemann
All providers in Fenton, MO · Registered Dietitian in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2024. 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.