Provider Demographics
NPI:1407746670
Name:BUCKY THE WONDERHORSE
Entity type:Organization
Organization Name:BUCKY THE WONDERHORSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WEICHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, PMHNP-BC
Authorized Official - Phone:303-956-7871
Mailing Address - Street 1:1905 N SHERMAN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1132
Mailing Address - Country:US
Mailing Address - Phone:303-956-7871
Mailing Address - Fax:
Practice Address - Street 1:6923 E VILLANOVA PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2648
Practice Address - Country:US
Practice Address - Phone:214-738-5561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty