Provider Demographics
NPI:1447351713
Name:BUCHANAN, ROBIN LEACH (APRN)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEACH
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BEMIDJI AVE N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 BEMIDJI AVE N
Practice Address - Street 2:SUITE 200
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3020
Practice Address - Country:US
Practice Address - Phone:218-213-8745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR090727-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner