Individual
MRS. KATYANN MARIE LUCEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
927 BROADWAY ST, QUINCY, IL 62301-2719
(217) 223-1200
Mailing address
927 BROADWAY ST, QUINCY, IL 62301-2719
(217) 223-0610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008509
IL
Other
Enumeration date
06/30/2021
Last updated
02/11/2022
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