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General NPI Number Information
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NPI Number | 1083413686
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Entity Type | Individual
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Provider Name | DANIELLE LUCAS RN
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Gender | Female
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 325 E H ST
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-4760
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Country | US
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Telephone | 906-774-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 127 E SOMO AVE
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City | TOMAHAWK
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State | WI
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Zip | 54487-1461
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Country | US
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Telephone | 715-612-0101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 246292-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 193400000X
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License Number State | MI
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