Individual
DE COURCY LUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
408 W 8TH ST, NATIONAL CITY, CA 91950-1002
(619) 474-8666
Mailing address
408 W 8TH ST, NATIONAL CITY, CA 91950-1002
(619) 474-8666
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
771431
CA
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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