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Individual

MRS. KSENIYA ALEKSEYEVNA LUECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1625 N 205TH ST, ELKHORN, NE 68022-4885
(402) 758-5452
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
127741
IA
363A00000X
Physician Assistant
Primary
2976
NE
363A00000X
Physician Assistant
4444
OK
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
10/25/2018
Last updated
02/05/2025
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