Marilyn Elizabeth Buckley, MSN, CFNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704118735 Issued in MI

Practice address

117 S. Burgess St.
West Branch, MI 48661

Phone

(989) 343-1367

Fax

(989) 343-1427

NPI assigned

Oct 23, 2006

Last updated

Oct 19, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Ms. Marilyn E Louis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McLaren Medical Group

  • General Practice Physician
  • West Branch, MI
  • NPI 1104294354
  NPD (past)
• Woodland Health Care Services PC

  • Emergency Medicine Physician
  • West Branch, MI
  • NPI 1578501292
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1871676049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S. BURGESS ST.",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "48661",
            "telephone_number": "989-343-1367",
            "fax_number": "989-343-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S. BURGESS ST.",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "48661",
            "telephone_number": "989-343-1367",
            "fax_number": "989-343-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "MARILYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MSN, CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704118735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46273355 TYPE 10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN PROV ID",
            "identifier": "5008703250",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "5008703250",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "23D1031156",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC NUMBER",
            "identifier": "4704118735",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "200893159",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "LOUIS",
            "middle_name": "E",
            "prefix": "MS.",
            "credential": "MSN, CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tanna Bregener
• Courtney Breining, RN
• Timothy Bronson, LPC
• Aliya Frances Browne, DO
• Sarah C. Bryce, PHARM D
• Kelly L Bulow, OD
• Dawn Burke-Allie
• Michael E Burkley, D.O.
• David Bryan Butcher, MD
• Camp Skywild

• Nurse Practitioner in West Branch, MI
• Providers in West Branch, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.