Provider Demographics
NPI:1164206611
Name:BUCKNER, MADISON (APRN)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:BUCKNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:SALCHERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:3907 PINOAK VIEW CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-5842
Mailing Address - Country:US
Mailing Address - Phone:734-474-9859
Mailing Address - Fax:
Practice Address - Street 1:10606 MEETING ST
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-5522
Practice Address - Country:US
Practice Address - Phone:859-554-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4008706363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily