Individual
JENNIFER A LUCEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1919 LATHROP ST STE 205, FAIRBANKS, AK 99701-5942
(608) 799-4335
Mailing address
1919 LATHROP ST STE 205, FAIRBANKS, AK 99701-5942
(608) 799-4335
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
160604
AK
363AM0700X
Medical Physician Assistant
3273-23
WI
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
160604
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710794
—
AK
Enumeration date
09/27/2012
Last updated
07/12/2023
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