EMILY BUCKMILLER SUPERNOVA

LOUISVILLE, KY
NPI1194228684
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: KY  PA2967)
Additional Taxonomies363A00000X Physician Assistant
(Licence: UT  10732519-1206)
363A00000X Physician Assistant
(Licence: MO  2018013895)
Enumeration Date2018-03-12
Last Update Date2022-09-27
Business Address
EMILY BUCKMILLER SUPERNOVA PA-C
4001 DUTCHMANS LN
LOUISVILLE, KY 40207-4714
Phone number: 502-559-3930
Mailing Address
EMILY BUCKMILLER SUPERNOVA PA-C
PO BOX 776879
CHICAGO, IL 60677-6879
Phone number: 502-588-9490