Individual
HEATHER L LUCKENBILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1701 INNOVATION DR, YORK, PA 17408-8815
(717) 850-4040
(717) 850-4144
Mailing address
1701 INNOVATION DR, YORK, PA 17408-8815
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN556384
PA
363L00000X
Nurse Practitioner
018033
PA
363L00000X
Nurse Practitioner
SP012880
PA
363LP0200X
Pediatric Nurse Practitioner
NJ00356100
NJ
363LP0200X
Pediatric Nurse Practitioner
Primary
SP012880
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NJ00356100
MEDICAL LICENSE
NJ
Enumeration date
12/14/2011
Last updated
07/23/2021
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