Individual
LUCILLE FRANCES LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
601 JOHN ST, BOX 74, KALAMAZOO, MI 49007-5341
(269) 341-7339
Mailing address
P.O. BOX 52, 48855 59 1/2 STREET, HARTFORD, MI 49057
(269) 637-0388
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704228927
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003822412
BCBSM - BRONSON METHODIST HOSPITAL
MI
05
—
1598067316
—
MI
Enumeration date
11/30/2010
Last updated
05/10/2011
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