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General NPI Number Information
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NPI Number | 1326545336
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Entity Type | Individual
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Provider Name | KAITLYN M LUCAS APRN
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Gender | Female
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Dates
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Enumeration Date | 04/07/2018
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 655 E RIVER RD STE 201
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City | TUCSON
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State | AZ
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Zip | 85704-5824
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Country | US
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Telephone | 520-258-0585
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Fax | 833-449-2358
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Provider Business Mailing Address
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Address Line | PO BOX 81064
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City | CLEVELAND
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State | OH
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Zip | 44181-0064
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Country | US
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Telephone | 520-795-0608
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Fax | 520-795-0354
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 251532
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License Number State | AZ
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