TEQUILA BUCKHANON

Home Health

Active Individual
NPI: 1477170777

Practice Address

5701 SHINGLE CREEK PKWY STE 250H
Brooklyn Center, MN 55430

Phone: (612) 695-5614

Specialties

Specialty Code Primary License
Non-emergency Medical Transport (VAN) 343900000X No -
Home Health 251E00000X Yes 10827598 (MN)

Frequently Asked Questions

NPI 1477170777 is the National Provider Identifier for TEQUILA BUCKHANON, a Home Health provider located in Brooklyn Center, MN. This NPI was enumerated on July 2, 2020.
TEQUILA BUCKHANON practices at 5701 SHINGLE CREEK PKWY STE 250H, Brooklyn Center, MN 55430.

Quick Facts

NPI
1477170777
Type
Individual
Enumerated
Jul 2, 2020
Last Updated
Jul 2, 2020

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