Individual
MONICA S LUCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8990 SPRINGBROOK DR NW, SUITE 250, COON RAPIDS, MN 55433-5850
(763) 398-1162
(763) 398-0124
Mailing address
1365 14TH AVE SE, FOREST LAKE, MN 55025-2077
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1179192
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016T1AN
BCBSMN
MN
05
—
610089900
—
MN
Enumeration date
08/09/2005
Last updated
05/22/2008
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