Individual
DR. JONATHAN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-BC
Contact information
Practice address
3200 MACCORKLE AVE SE FL 5, CHARLESTON, WV 25304-1227
(304) 388-4600
(304) 388-4603
Mailing address
3200 MACCORKLE AVE SE FL 5, CHARLESTON, WV 25304-1227
(304) 388-4600
(304) 388-4603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
75558
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810030131
—
WV
Enumeration date
07/17/2015
Last updated
10/10/2024
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