Buckley, Lisa Marie

Buckley, Lisa Marie is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Buckley, Lisa Marie can be contacted via phone (774) 441-8270.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (774) 441-8270
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN283523 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X RN283523 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN283523 Massachusetts

Profile Details

NPI number 1679959480
LBN Legal business name Buckley, Lisa Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2015
Last updated Mar 8th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679959480 NPPES
Massachusetts MEDICAID 110104955A

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