Individual
NICOLE LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
149 WINDING RIDGE DR, DAYTON, OH 45415-2820
(937) 603-8243
Mailing address
149 WINDING RIDGE DR, DAYTON, OH 45415-2820
(937) 603-8243
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
134794
OH
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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