Individual
MARY VIRGINIA GIRARDEAU LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C, PMHNP
Contact information
Practice address
401 WITSELL ST, WALTERBORO, SC 29488-3052
(843) 549-5546
Mailing address
2030 POWERS FERRY RD SE, SUITE 120, ATLANTA, GA 30339-2823
(678) 801-2313
(844) 249-2637
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19050
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
19050
SC
Other
Enumeration date
09/15/2014
Last updated
01/02/2025
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