Individual
JEANNE LOUISE LUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN, CFNP
Contact information
Practice address
8290 UNIVERSITY AVE NE, SUITE 200, FRIDLEY, MN 55432-1847
(763) 786-9543
(763) 786-3320
Mailing address
6465 WAYZATA BLVD, SUITE 900, ST LOUIS PARK, MN 55426-1728
(952) 512-5600
(952) 512-5650
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R105398-8
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114567
MEDICA
—
01
—
123231E949
UCARE
—
01
—
134K1LU
BLUECROSS BLUESHIELD
—
05
—
941319700
—
MN
01
—
969991017871
PREFERREDONE
—
01
—
HP30388
HEALTHPARTNERS
—
Enumeration date
07/18/2006
Last updated
07/10/2007
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