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NPI Code Detail

MEDICARE: PRESTON LUKE FNP

MEDICARE: PRESTON LUKE FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse801295TX
2363LF0000XFamily Nurse PractitionerAP140030TX

General Provider Information

NPI Number : 1518436252
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRESTON LUKE FNP
Provider Business Mailing Address
First Line : PO BOX 11538
Second Line :
City : KILLEEN
State : TX
Zip : 76547-1538
Country : US
Telephone Number : 254-245-9177
Fax Number : 254-245-9178
Provider Business Practice Location Address
First Line : 710 E 6TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-4655
Country : US
Telephone Number : 254-245-9175
Fax Number : 254-213-7771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2018
Last Update Date : 01/20/2025

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