MEDICARE: DR. NANCY CAROL LUCKIE M.D.

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
1	2084P0800X	Psychiatry Physician	5344	HI
2	2084P0800X	Psychiatry Physician	MD-5344	HI

General Provider Information

NPI Number	:	1760578116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY CAROL LUCKIE M.D.

Provider Business Mailing Address
First Line	:	1330 ALA MOANA BLVD APT 2204
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-4230
Country	:	US
Telephone Number	:	808-955-7372
Fax Number	:	808-951-9282

Provider Business Practice Location Address
First Line	:	1188 BISHOP ST STE 2702
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3311
Country	:	US
Telephone Number	:	808-955-7372
Fax Number	:	808-951-9282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	01/22/2025

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