Provider Demographics
NPI:1689097156
Name:BUCK, NIKKI (FNP-C)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:BUCK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 YELLOWSTONE AVENUE
Mailing Address - Street 2:
Mailing Address - City:WEST YELLOWSTONE
Mailing Address - State:MT
Mailing Address - Zip Code:59758-8946
Mailing Address - Country:US
Mailing Address - Phone:406-646-9441
Mailing Address - Fax:406-646-1150
Practice Address - Street 1:236 YELLOWSTONE AVENUE
Practice Address - Street 2:
Practice Address - City:WEST YELLOWSTONE
Practice Address - State:MT
Practice Address - Zip Code:59758-8946
Practice Address - Country:US
Practice Address - Phone:406-646-9441
Practice Address - Fax:406-646-1150
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-100594363LF0000X
WAAP60443724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily