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Individual
NICOLE K. LUETKE
Active
Individual
NICOLE K. LUETKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS012680
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012761050001
—
PA
01
—
1132437
AETNA HMO
PA
01
—
11555034
CAQH ID#
PA
01
—
1735036
HIGHMARK BLUE SHIELD
PA
01
—
2402357000
IBC - PC/KHPE
PA
01
—
30025600
KEYSTONE MERCY
PA
01
—
5855528
CIGNA HMO/PPO
PA
01
—
7722728
AETNA PPO
PA
Enumeration date
05/20/2006
Last updated
11/15/2018
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