Individual
LISA TAYLOR LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
NORTHWEST HOSPITAL, 5401 OLD COURT ROAD, RANDALLSTOWN, MD 21133
(410) 521-2200
Mailing address
3311 MIDFIELD RD, BALTIMORE, MD 21208-4406
(410) 868-9872
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
10/16/2018
Last updated
04/29/2022
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