Individual
TARA LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.N.
Contact information
Practice address
834 N SEMINARY ST, SUITE 502, GALESBURG, IL 61401-2852
(309) 343-2262
(309) 343-2081
Mailing address
834 N SEMINARY ST, SUITE 502, GALESBURG, IL 61401-2852
(309) 343-2262
(309) 343-2081
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209008416
IL
363LF0000X
Family Nurse Practitioner
041278068
IL
Other
Enumeration date
09/14/2010
Last updated
10/15/2010
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