Bucilla Health Services LLC
Nurse Practitioner, Psych/Mental Health in Burnsville Mn, MN. Organization (NPI-2).
NPI number1356830756
StatusActive
Last updated in NPPESSep 22, 2020
Details
- NPI
- 1356830756
- Entity type
- Organization (NPI-2)
- Legal business name
- Bucilla Health Services LLC
- Organization subpart
- No
- Enumeration date
- May 2, 2018
- Certification date
- Sep 22, 2020
- Last updated
- Sep 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | R156407-9 | MN | Yes |
Practice location
1500 McAndrews Rd WBurnsville Mn, MN 55337
Phone 952-892-9393 · Fax 952-892-9395
Mailing address
1500 McAndrews Rd WBurnsville Mn, MN 55337
Phone 952-892-9393 · Fax 952-892-9395
Authorized official
Pennie Elizabeth Bucilla
Owner
9528929393
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