Individual
AMANDA ELIZABETH LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 403-6567
Mailing address
139 DEEP CREEK DR, SHEPHERDSVILLE, KY 40165-8686
(502) 303-3344
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1127726
KY
363L00000X
Nurse Practitioner
3011963
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3011963
KY
Other
Enumeration date
01/04/2018
Last updated
01/09/2018
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