Provider Demographics
NPI:1386158194
Name:BUCKLAND, STEVEN PERRY (LPN)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:PERRY
Last Name:BUCKLAND
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 DAWN CT APT 1
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1354
Mailing Address - Country:US
Mailing Address - Phone:330-635-7580
Mailing Address - Fax:
Practice Address - Street 1:2301 SCRANTON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-4311
Practice Address - Country:US
Practice Address - Phone:216-273-6998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.146186.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse