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NPI Code Detail

MEDICARE: ABIGAIL MARIE LUCAS PA-C

MEDICARE: ABIGAIL MARIE LUCAS PA-C
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
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant5196TN

General Provider Information

NPI Number : 1558931709
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL MARIE LUCAS PA-C
Provider Business Mailing Address
First Line : 5108 MICHIGAN AVE
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-2050
Country : US
Telephone Number : 133-026-6979
Fax Number :
Provider Business Practice Location Address
First Line : 333 MURFREESBORO PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37210-2877
Country : US
Telephone Number : 615-248-1225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2021
Last Update Date : 01/11/2023

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Directions to “ ABIGAIL MARIE LUCAS PA-C” Practice Location

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