Provider Demographics
NPI:1336582725
Name:BUCHBERGER, KAREN GENEIEVE (LPN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:GENEIEVE
Last Name:BUCHBERGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 FREEDOM RD
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9451
Mailing Address - Country:US
Mailing Address - Phone:920-336-7506
Mailing Address - Fax:
Practice Address - Street 1:3003 FREEDOM RD
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9451
Practice Address - Country:US
Practice Address - Phone:920-336-7506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20019-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse