Individual
CALI R LUECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3021 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 496-7000
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12088
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12088-33
WISCONSIN STATE FNP LICENSE
WI
01
—
F06220827
AMERICAN ACADEMY OF NURSE PRACTITIONERS
—
Enumeration date
07/15/2022
Last updated
10/24/2023
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