Carol A Buckels, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R550191 Issued in MS

Practice address

201 S Railroad Ave
Brookhaven, MS 39601-3331

Phone

(601) 835-0077

Fax

(601) 835-0095

NPI assigned

Aug 17, 2006

Last updated

Jun 18, 2008By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1972616332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S RAILROAD AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013331",
            "telephone_number": "601-835-0077",
            "fax_number": "601-835-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S RAILROAD AVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013331",
            "telephone_number": "601-835-0077",
            "fax_number": "601-835-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKELS",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R550191",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R550191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124865",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bathsheba Brown
• Elizabeth Whitaker Brown, MSN, RN
• Stacy Maurice Brown, FNP-BC
• Anna Catherine Bruce, DMD
• Shana M Brumfield Lewis
• Michael Burch, CNLP, CH
• Charles Nickolas Burns, RN, MSN
• Kimberly Burr, ATC,LAT
• Makieta Byrd
• Shanijua E Byrd

• Nurse Practitioner in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.