Provider Demographics
NPI:1053940882
Name:BUCIO, ELSA CAMPOS (FNP-C)
Entity type:Individual
Prefix:
First Name:ELSA
Middle Name:CAMPOS
Last Name:BUCIO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 US HIGHWAY 158 W
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-8304
Mailing Address - Country:US
Mailing Address - Phone:336-694-9331
Mailing Address - Fax:
Practice Address - Street 1:207 E MEADOW RD STE 6
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-3469
Practice Address - Country:US
Practice Address - Phone:363-864-2795
Practice Address - Fax:336-694-7511
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178537363LF0000X
NC5014738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily