Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 5101019166 | MI |
Y | 2080P0210X | Pediatric Nephrologist | 5101019166 | MI |
N | 2080P0210X | Pediatric Nephrologist | MB 07863400 | NJ |
N | 2080P0210X | Pediatric Nephrologist | OP00002005 | WA |
N | 2080P0210X | Pediatric Nephrologist | OS 012710 | PA |
NPI | 1346358595 |
---|---|
Provider Name | Kera E Luckritz |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 17/06/2013 |