Individual
ANNA MARIE LUKENS-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-1000
Mailing address
343 N BELAIR DR, CUSTER, SD 57730-1011
(605) 321-7804
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
40924.1718
WY
390200000X
Student in an Organized Health Care Education/Training Program
201505577RN
OR
Other
Enumeration date
09/14/2015
Last updated
03/17/2018
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