Healthcare Provider Details
I. General information
NPI: 1679509418
Provider Name (Legal Business Name): ANNE MARIE LUCAS RN MSN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/23/2006
Last Update Date: 11/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 WESTAGE BUSINESS CTR DR
FISHKILL NY
12524-2281
US
IV. Provider business mailing address
600 WESTAGE BUSINESS CTR DR
FISHKILL NY
12524-2281
US
V. Phone/Fax
- Phone: 845-231-5560
- Fax: 845-231-5489
- Phone: 845-231-5600
- Fax: 845-231-5489
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | F334826 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: