Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | ARNP9166174 | FL |
NPI | 1184071334 |
---|---|
Provider Name | Mrs. Cindy Lucas |
First Address | Fort Myers, FL 33905-8716 |
Second Address | Fort Myers, FL 33908-3618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2016 |
Last Update Date | 27/05/2016 |