Individual
MELISSA JADE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2203
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.340455
OH
367500000X
Certified Registered Nurse Anesthetist
15178NA
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
28054
SC
Other
Enumeration date
09/19/2013
Last updated
01/18/2024
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