Individual
JESSICA LEE LUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3728 SEAMIST DR, GAUTIER, MS 39553-5426
(228) 990-9977
Mailing address
3728 SEAMIST DR, GAUTIER, MS 39553-5426
(228) 990-9977
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-095313
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009938166
—
AL
05
—
04878079
—
MS
01
—
51535829
BLUE SHIELD
AL
Enumeration date
07/27/2006
Last updated
02/12/2016
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