Kaitlin Buckner, P.A.

NPI 1104852094ActiveIndividual· Physician Assistant· Woodbury, MN

Physician Assistant (P.A.) with Bristol Bay Area Health Corporation, practicing in Woodbury, Minnesota. Part D covered 12 prescriptions written in 2024. Lists Bristol Bay DBA Kanakanak Hospital as a hospital affiliation.

Overview

NPI	1104852094
Status	Active
Entity type	Individual
Credential	P.A.
Sole proprietor	No
NPI issued	Jun 23, 2006
Last updated in NPPES	May 18, 2025
Certified by provider	May 18, 2025

Specialties and licenses

Taxonomy	Code	License	State
Physician Assistant Primary	363A00000X	10495	MN
Physician Assistant	363A00000X	6669778-1206	UT
Physician Assistant	363A00000X	3127	AZ
Physician Assistant	363A00000X	1414	OK
Physician Assistant	363A00000X	PA223121	OR
Physician Assistant	363A00000X	PADA1230	AK
Physician Assistant	363A00000X	PA65471	CA

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Oct 9, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 4, 2026	No match	—
New York OMIG · Nov 4, 2026	No match	—
Ohio Medicaid · Nov 4, 2026	No match	—
Pennsylvania Medicheck · Nov 4, 2026	No match	—
Washington HCA · Nov 4, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Practitioner - Physician Assistant (AK); Practitioner - Physician Assistant (MN); Practitioner - Physician Assistant (OR); Practitioner - Physician Assistant (TX); Practitioner - Physician Assistant (WA)