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General NPI Number Information
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NPI Number | 1205533031
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Entity Type | Organization
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Legal Business Name | THE LUCCA GROUP LLC
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 702 CHURCH ST
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City | HAWLEY
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State | PA
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Zip | 18428-1412
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Country | US
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Telephone | 272-336-0101
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Fax | 272-336-0102
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Provider Business Mailing Address
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Address Line | 702 CHURCH ST
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City | HAWLEY
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State | PA
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Zip | 18428-1412
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Country | US
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Telephone | 272-336-0101
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Fax | 272-336-0102
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | APRIL POWELL
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Credential |
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Telephone | 814-826-0500
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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