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Individual

MISS KATHRYN AMELIA LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
400 W 16TH ST, PUEBLO, CO 81003-2781
(719) 584-4306
(719) 595-7886
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0068474
CO
207P00000X
Emergency Medicine Physician
OT018677
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000207320
CO
Enumeration date
06/21/2018
Last updated
03/18/2025
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