Basic Information
| Provider Information | |||||||||
| NPI: | 1821591991 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUECHE | ||||||||
| FirstName: | ALICIA | ||||||||
| MiddleName: | ROBERTA | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 830 S 33RD ST | ||||||||
| Address2: | |||||||||
| City: | SOUTH BEND | ||||||||
| State: | IN | ||||||||
| PostalCode: | 466152323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5745208368 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8988 E US HIGHWAY 20 | ||||||||
| Address2: | |||||||||
| City: | NEW CARLISLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 465529038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5746547779 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2018 | ||||||||
| LastUpdateDate: | 09/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 28207642A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 71008073A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.