Individual
MICHAEL LUEBKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
14083-33
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
14083
WI
367500000X
Certified Registered Nurse Anesthetist
143317
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598441594
—
WI
Enumeration date
06/26/2023
Last updated
08/25/2023
Update your record
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