Individual
DANIEL S LUCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP-C, GNP-C,
Contact information
Practice address
2501 MCHENRY AVE, SUITE F, MODESTO, CA 95350-3259
(209) 522-9054
Mailing address
201 E RUMBLE RD, SUITE E, MODESTO, CA 95350-2356
(209) 527-7777
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19377
CA
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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