Shareen Buckner, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R609536 Issued in MS

Practice address

133 Scanlan St
La-Z-Boy South Clinic
Newton, MS 39345-2329

Phone

(601) 683-1375

Fax

(601) 683-4120

NPI assigned

Nov 13, 2006

Last updated

Nov 30, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1841361714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5492 FRED HAGUEWOOD RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393018413",
            "telephone_number": "601-644-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 SCANLAN ST",
            "address_2": "LA-Z-BOY SOUTH CLINIC",
            "city": "NEWTON",
            "state": "MS",
            "postal_code": "393452329",
            "telephone_number": "601-683-1375",
            "fax_number": "601-683-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "SHAREEN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R609536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0118227",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laticia Bickham, LPC
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• Calli Boggan
• Bridges Health Clinic
• Allison B Brunson
• Central Mississippi Residential Center
• Rebecca Marie Coonce
• Morgan Craven
• Rhonda P. Davis, FNP
• William Gil Davis, OD

• Family Nurse Practitioner in Newton, MS
• Providers in Newton, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.