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Individual

MRS. ANN ELIZABETH LUTKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
971 LAKELAND DR STE 1250, JACKSON, MS 39216-4609
(601) 200-5955
(601) 200-5943
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(601) 200-2990
(225) 765-9196

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
R875444
MS
363L00000X
Nurse Practitioner
875444
MS
363LF0000X
Family Nurse Practitioner
Primary
875444
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09702355
MS
01
P01668935
RAILROAD MEDICARE
MS
Enumeration date
04/15/2010
Last updated
10/29/2025
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