Individual
MS. KELLY SUZANNE LUCKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2835 CHARTER DR, TROY, MI 48083-1306
(248) 885-1291
Mailing address
2835 CHARTER DR, TROY, MI 48083-1306
(248) 885-1291
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4704247609
MI
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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