Individual
DELORES A LUCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-FNP
Contact information
Practice address
818 ARBUCKLE ROAD, SUITE 102, SUMMERSVILLE, WV 26651-1086
(304) 883-2310
(304) 883-2312
Mailing address
818 ARBUCKLE ROAD, SUITE 102, SUMMERSVILLE, WV 26651-1086
(304) 883-2310
(304) 883-2312
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
44396
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7102018000
—
WV
Enumeration date
08/22/2006
Last updated
04/13/2010
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