Individual
MS. ALA BIANCA NAOMI LUCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1718 SAINT JULIAN PL, COLUMBIA, SC 29204-2410
(803) 708-8392
Mailing address
753 S SAGE DROP RD, BLYTHEWOOD, SC 29016-9265
(803) 200-3748
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
21969
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5843
—
SC
Enumeration date
06/27/2018
Last updated
06/29/2026
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