Individual
DIANA LYNN LUCKHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2622 HEARTLAND BLVD, IONIA, MI 48846-8757
(517) 913-3860
(517) 484-6864
Mailing address
1703 EAST MICHIGAN AVENUE, LANSING, MI 48912
(517) 913-3860
(517) 484-6864
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704130092
MI
Other
Enumeration date
10/18/2011
Last updated
10/24/2011
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