Healthcare Provider Details

I. General information

NPI: 1326330721
Provider Name (Legal Business Name): EUNICE S LUCAS RN/PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 05/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TER HEUN DR
FALMOUTH MA
02540-2525
US

IV. Provider business mailing address

PO BOX 2045
MASHPEE MA
02649-8045
US

V. Phone/Fax

Practice location:
  • Phone: 508-540-6550
  • Fax:
Mailing address:
  • Phone: 508-737-9162
  • Fax: 508-477-0662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN 156 166
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: