Carol R Luckey
Nurse Practitioner Nurse Practitioner - Primary Care
120 E Church St
Lexington
, Tennessee 38351
Carol R Luckey
Nurse Practitioner Nurse Practitioner - Primary Care
120 E Church St
Lexington
, Tennessee 38351
(731) 660-9055
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About
Features
Specialties
- Nurse Practitioner
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Carol R Luckey
- P.o Box 11567
- Jackson, TN
- Zip : 38308
- Fax : (731) 660-9055
- Phone : (731) 661-0086
Second Address
- Carol R Luckey
- 120 E Church St
- Lexington, TN
- Zip : 38351
- Fax : (731) 968-9398
- Phone : (731) 968-0146
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | APN5691 | TN |
| Y | 363LP2300X | Nurse Practitioner - Primary Care | APN0000005691 | TN |
National Provider Identifier
| NPI | 1003858150 |
|---|---|
| Provider Name | Carol R Luckey |
| First Address | Jackson, TN 38308 |
| Second Address | Lexington, TN 38351 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/06/2006 |
| Last Update Date | 12/10/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0000000031363 | MEMPHIS MANAGED CARE (TLC (01) | TN |
| 156102 | UNISON (01) | TN |
| 3900686 | (05) | TN |
| 39006861 | (05) | TN |
| 4083540 | BLUE CROSS BLUE SHIELD TN (01) | TN |
| 4083540 | TN CARE SELECT (01) | TN |
| 4157526 | BLUE CROSS BLUE SHIELD TN (01) | |
| S68392 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.