Individual
TARA LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
321 MAIN ST STE 4F, JOHNSTOWN, PA 15901-1632
(814) 254-4905
Mailing address
2525 FIELDSTONE AVE, SUMMERHILL, PA 15958-4106
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN646306
PA
363L00000X
Nurse Practitioner
Primary
SP029579
PA
Other
Enumeration date
09/20/2017
Last updated
04/25/2024
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