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General NPI Number Information
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NPI Number | 1144292392
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Entity Type | Individual
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Provider Name | LYNDA CELESTE LUTZKE NP
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Gender | Female
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | S.76 W.19774 SUNNY HILL DR.
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City | MUSKEGO
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State | WI
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Zip | 53150-9235
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Country | US
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Telephone | 262-679-2399
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Fax |
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Provider Business Mailing Address
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Address Line | S.76 W.19774 SUNNY HILL DR.
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City | MUSKEGO
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State | WI
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Zip | 53150-9235
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Country | US
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Telephone | 262-679-2399
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 985-033
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License Number State | WI
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