Tequila Buckhanon

NPI 1477170777 · on the registry since 2020 · sole proprietor

Practice

Address: 5701 Shingle Creek Pkwy Ste 250h
Brooklyn Center, MN 55430
Phone: (612) 695-5614
Organisation at this address: All Love Inc
Leaflower Llc
Lifechoice Llc
Clearhaven Llc
Care Rides Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 48

Registry record

Primary taxonomy: 251E00000X
251E00000X
Also registered as: 343900000X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2020-07-02

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota