Provider Demographics
NPI:1356225544
Name:BRIAR CREEK FAMILY CARE
Entity type:Organization
Organization Name:BRIAR CREEK FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:706-834-3731
Mailing Address - Street 1:1 CHATHAM STREET EXT
Mailing Address - Street 2:
Mailing Address - City:SARDIS
Mailing Address - State:GA
Mailing Address - Zip Code:30456-2000
Mailing Address - Country:US
Mailing Address - Phone:706-834-3731
Mailing Address - Fax:
Practice Address - Street 1:639 VESTAL RD
Practice Address - Street 2:
Practice Address - City:SARDIS
Practice Address - State:GA
Practice Address - Zip Code:30456-2155
Practice Address - Country:US
Practice Address - Phone:706-834-3731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty