Healthcare Provider Details

I. General information

NPI: 1861282824
Provider Name (Legal Business Name): RHIANNON LUCAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 WALKER AVE
GREENSBORO NC
27403
US

IV. Provider business mailing address

1007 WALKER AVE
GREENSBORO NC
27403
US

V. Phone/Fax

Practice location:
  • Phone: 252-373-6575
  • Fax:
Mailing address:
  • Phone: 252-373-6575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5025104
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number295520
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: