Individual
CARRIE A LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
515 E PROMENADE ST, MEXICO, MO 65265-2966
(573) 581-0157
(573) 581-4995
Mailing address
PO BOX 1027, JEFFERSON CITY, MO 65102-1027
(573) 681-3767
(573) 761-6947
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2002017293
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213660
BLUE SHIELD
MO
05
—
421197005
—
MO
01
—
758224
HEALTHLINK
MO
Enumeration date
07/21/2006
Last updated
03/05/2024
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