Individual provider · NPI-1

Jaime Lynn Buckelew, CSFA

Specialist/Technologist, Other, Surgical Assistant · Marietta, GA

NPI number1700366606
StatusActive
Last updated in NPPESAug 20, 2018

Details

NPI
1700366606
Entity type
Individual (NPI-1)
Name
Jaime Lynn Buckelew
Credential
CSFA
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 20, 2018
Last updated
Aug 20, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246ZC0007X Specialist/Technologist, Other, Surgical Assistant164724GAYes

Practice location

800 Kennesaw Ave Nw Ste 120
Marietta, GA 30060-1052

Phone 678-556-5138 · Fax 770-336-6620

Mailing address

800 Kennesaw Ave Nw Ste 120
Marietta, GA 30060-1052

Phone 678-556-5138 · Fax 770-336-6620

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