Individual
MRS. KIMBERLY G LUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
505 JENKINS ST, LAGRANGE, GA 30240-4225
(706) 407-0161
(706) 756-1404
Mailing address
505 JENKINS ST, LAGRANGE, GA 30240-4225
(706) 407-0161
(706) 756-1404
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN285427
GA
Other
Enumeration date
10/29/2019
Last updated
07/29/2021
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