MEDICARE: MS. CHRISTY M LUCAS APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	12976	TN

General Provider Information

NPI Number	:	1457529661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTY M LUCAS APN

Provider Business Mailing Address
First Line	:	472 W POPLAR AVE STE 201
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2538
Country	:	US
Telephone Number	:	901-854-5771
Fax Number	:	901-854-5774

Provider Business Practice Location Address
First Line	:	472 W POPLAR AVE STE 201
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2538
Country	:	US
Telephone Number	:	901-854-5771
Fax Number	:	901-854-5774

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	12/12/2022

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