Individual
MRS. REBECCA LYNN LUCKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3400 W 66TH ST STE 290, EDINA, MN 55435-2133
(952) 914-1797
Mailing address
3400 W 66TH ST STE 290, EDINA, MN 55435-2133
(612) 419-1759
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
R1792650
MN
Other
Enumeration date
10/18/2012
Last updated
02/16/2016
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