Provider Demographics
NPI:1043357551
Name:BUCHANAN, THERESA ANN (FNP)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 PULASKI GILES TPKE
Mailing Address - Street 2:
Mailing Address - City:PEARISBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24134-2607
Mailing Address - Country:US
Mailing Address - Phone:540-921-3174
Mailing Address - Fax:
Practice Address - Street 1:CHARLES W SCHIFFERT HEALTH CTR
Practice Address - Street 2:MCCOMAS HALL
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24061-0001
Practice Address - Country:US
Practice Address - Phone:540-231-5313
Practice Address - Fax:540-231-7473
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024167130363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool