Provider Demographics
NPI:1861093544
Name:BUCHNER, ERICA ANN (RPSGT, CCSH, CSE)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ANN
Last Name:BUCHNER
Suffix:
Gender:F
Credentials:RPSGT, CCSH, CSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13397 EUROPA CT N UNIT 3
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-4497
Mailing Address - Country:US
Mailing Address - Phone:651-353-4590
Mailing Address - Fax:
Practice Address - Street 1:13397 EUROPA CT N UNIT 3
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-4497
Practice Address - Country:US
Practice Address - Phone:651-353-4590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN275246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other