Individual
MRS. ARIEL LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
2680 W CENTRE AVE, PORTAGE, MI 49024-4828
(269) 858-8993
Mailing address
2680 W CENTRE AVE, PORTAGE, MI 49024-4828
(269) 324-2400
(269) 324-0450
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4704355922
MI
363L00000X
Nurse Practitioner
Primary
4704355922
MI
Other
Enumeration date
02/10/2021
Last updated
10/16/2024
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