Individual
LUCAS ALLEN FUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
20306 BADGER LANE, ONLEY, VA 23418-0159
(757) 787-7374
(757) 787-4581
Mailing address
20306 BADGER LANE, ONLEY, VA 23418-0159
(757) 787-7374
(757) 787-4581
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024170248
VA
Other
Enumeration date
09/07/2012
Last updated
04/14/2014
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