Individual
CHARLENE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
110 IVY MNR, STOCKBRIDGE, GA 30281-6433
(678) 708-9395
Mailing address
110 IVY MNR, STOCKBRIDGE, GA 30281-6433
(678) 708-9395
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN209824
GA
Other
Enumeration date
01/01/2025
Last updated
01/03/2025
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