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General NPI Number Information
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NPI Number | 1942938527
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Entity Type | Individual
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Provider Name | JEFFREY LUGTU SUN MSN,BSN,CPE,FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 10240 CALUMET AVE
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City | MUNSTER
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State | IN
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Zip | 46321-4082
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Country | US
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Telephone | 219-440-5286
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Fax |
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Provider Business Mailing Address
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Address Line | 10240 CALUMET AVE
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City | MUNSTER
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State | IN
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Zip | 46321-4082
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Country | US
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Telephone | 219-440-5286
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71012833A
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License Number State | IN
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