Individual
MARY C LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5200 HARROUN RD, SYLVANIA, OH 43560-2168
(419) 824-1305
(419) 824-1393
Mailing address
2914 S REPUBLIC BLVD, TOLEDO, OH 43615-1912
(419) 531-8808
(419) 531-9342
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN139727
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362701
ANTHEM
OH
05
—
0768594
—
OH
01
—
341877986019
MMOH
OH
01
—
341877986020
MMOH
OH
Enumeration date
07/05/2006
Last updated
07/09/2007
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