Individual
JESSYCA LUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
5590 KIETZKE LN, RENO, NV 89511-3019
(775) 323-2080
Mailing address
535 HAMMIL LANE, RENO, NV 89511
(775) 825-1234
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
RN43826
NV
207T00000X
Neurological Surgery Physician
Primary
823747
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE
—
Enumeration date
11/24/2015
Last updated
08/26/2019
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