Individual
LUCAS JAMES TLACHAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8350
(920) 288-8355
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 490-9046
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
236493-30
WI
363L00000X
Nurse Practitioner
Primary
12158-33
WI
363LF0000X
Family Nurse Practitioner
12158-33
WI
Other
Enumeration date
06/02/2022
Last updated
04/28/2026
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