Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APRN.CNP.0029253 | OH |
NPI | 1144808908 |
---|---|
Provider Name | Kaitlyn Paige Lucas |
First Address | Covington, KY 41017-9114 |
Second Address | Cincinnati, OH 45219-2989 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2021 |
Last Update Date | 09/07/2021 |