Individual
SHANNON RENEE LUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1416 CUSTER DR., ERIE, PA 16505
(814) 218-9405
Mailing address
1416 CUSTER DR., ERIE, PA 16505
(814) 218-9405
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN282605
PA
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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