Individual
KIMBERLY LUCAITIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
600 GRANT ST, GARY, IN 46402-6001
(219) 886-4464
Mailing address
600 GRANT ST, GARY, IN 46402-6001
(219) 886-4464
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28141967A
IN
Other
Enumeration date
09/27/2011
Last updated
11/18/2016
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