Healthcare Provider Details

I. General information

NPI: 1760458004
Provider Name (Legal Business Name): EUGENE T LUCAS CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 NTH 11TH STREET
SUNBURY PA
17801-1611
US

IV. Provider business mailing address

PO BOX 1388
KINGSTON PA
18704-0388
US

V. Phone/Fax

Practice location:
  • Phone: 570-286-3430
  • Fax:
Mailing address:
  • Phone: 570-288-8881
  • Fax: 570-288-8065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP008837
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: