Individual
CARRIE L LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1307 S MAIN ST, LOCKWOOD, MO 65682-8327
(417) 232-4560
(417) 232-4611
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013001557
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841538287
—
MO
01
—
431560263
TRICARE
MO
01
—
P01159456
RR MCR
MO
Enumeration date
01/18/2013
Last updated
05/17/2013
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