Individual
JEFFREY LUECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
130 W BRUCE ST, 200, MILWAUKEE, WI 53204-1667
(414) 384-1400
(414) 672-7012
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5508
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034923
—
WI
Enumeration date
09/23/2013
Last updated
11/19/2021
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