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Individual

MS. ELIZABETH ANNE LUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
N2444 DORIS ST, DELAVAN, WI 53115-3379
(262) 203-3467
Mailing address
N2444 DORIS ST, DELAVAN, WI 53115-3379
(262) 203-3467

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
99616-030
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38330600
IPN
WI
Enumeration date
06/15/2010
Last updated
06/15/2010
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