Individual
COLLEEN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
101 W KOENIG LN STE 100, AUSTIN, TX 78751-1213
(512) 454-9426
(512) 454-7294
Mailing address
701 N VISTA RIDGE BLVD APT 12310, CEDAR PARK, TX 78613-0024
(512) 905-0229
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
821777
TX
363L00000X
Nurse Practitioner
Primary
AP138801
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP138801
APRN LICENSE
TX
Enumeration date
05/05/2018
Last updated
09/30/2019
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