Individual
TAMIQUA JACKSON LUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP-BC
Contact information
Practice address
8406 SIX FORKS RD STE 104, RALEIGH, NC 27615-3075
(919) 642-4857
(855) 484-7483
Mailing address
8406 SIX FORKS RD STE 104, RALEIGH, NC 27615-3075
(919) 642-4857
(855) 484-7483
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
5006558
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5006558
NC
Other
Enumeration date
09/17/2013
Last updated
12/02/2023
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