Individual
CAROL R LUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APN5691
TN
363LP2300X
Primary Care Nurse Practitioner
Primary
APN0000005691
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000031363
MEMPHIS MANAGED CARE (TLC
TN
01
—
156102
UNISON
TN
05
—
3900686
—
TN
05
—
39006861
—
TN
01
—
4083540
TN CARE SELECT
TN
01
—
4157526
BLUE CROSS BLUE SHIELD TN
—
Enumeration date
06/12/2006
Last updated
10/12/2011
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