Individual
JOAN MARIE LUCKEY
Active
Individual
JOAN MARIE LUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-001759
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-001759
STATE LICENSE NUMBER
IL
Enumeration date
11/16/2006
Last updated
03/10/2011
Update your record
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