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General NPI Number Information
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NPI Number | 1851238158
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Entity Type | Individual
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Provider Name | MCKENNA NICOLE LUKASIEWICZ
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Gender | Female
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 3919 NEWBERRY RD STE 4
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City | GAINESVILLE
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State | FL
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Zip | 32607-4828
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Country | US
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Telephone | 352-373-7984
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Fax | 352-224-1974
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Provider Business Mailing Address
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Address Line | 2930 SW 23RD TER APT 2503
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City | GAINESVILLE
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State | FL
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Zip | 32608-2957
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Country | US
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Telephone | 813-943-3547
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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