Provider Demographics
NPI:1154955821
Name:BUCHNER, JENNIFER M (ND)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:BUCHNER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 FULTON ST W STE B
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-5312
Mailing Address - Country:US
Mailing Address - Phone:616-264-6556
Mailing Address - Fax:616-432-3564
Practice Address - Street 1:638 FULTON ST W STE B
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-5312
Practice Address - Country:US
Practice Address - Phone:616-264-6556
Practice Address - Fax:616-432-3564
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2020-01175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath