Individual
MICHELLE A LUECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 4TH AVE, ENDERLIN, ND 58027-1325
(701) 437-3320
(701) 437-3323
Mailing address
201 4TH AVE, ENDERLIN, ND 58027-1325
(701) 437-3320
(701) 437-3323
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0150
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012890200
—
MN
05
—
71086
—
ND
Enumeration date
07/17/2006
Last updated
03/04/2022
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