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General NPI Number Information
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NPI Number | 1164347142
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Entity Type | Individual
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Provider Name | ELLEN LUKE RN, BSN, CLC
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Gender | Female
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 775 MALABAR RD
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City | MALABAR
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State | FL
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Zip | 32950-3112
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Country | US
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Telephone | 321-241-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 4906 BUTTONWOOD DR
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City | MELBOURNE
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State | FL
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Zip | 32940-1436
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Country | US
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Telephone | 321-241-6800
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 9679774
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License Number State | FL
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