Individual
MRS. DENISE RYAN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
138 E MAIN ST, SUITE 202, KENT, OH 44240-1407
(330) 678-8011
(330) 678-3877
Mailing address
138 E MAIN ST, SUITE 202, KENT, OH 44240-1407
(330) 678-8011
(330) 678-3877
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
NP07979
OH
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
NP07979
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2679098
MEDICAID LEGACY NUMBER
OH
01
—
NP18052
MEDICARE PTAN
OH
Enumeration date
06/29/2006
Last updated
10/21/2014
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