Individual
JENNAFER LUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4200 ALTAMONT PL, WHITE PLAINS, MD 20695-3052
(301) 645-2774
Mailing address
2214 GARDEN LN, BRYANS ROAD, MD 20616-3258
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R206616
MD
Other
Enumeration date
11/13/2016
Last updated
12/26/2019
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