Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN206976 | GA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN206976 | GA |
NPI | 1023498466 |
---|---|
Provider Name | Caroline Lukano |
First Address | Columbus, GA 31904-8725 |
Second Address | Columbus, GA 31904-8725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2015 |
Last Update Date | 27/09/2017 |