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NPI Code Detail

MEDICARE: LUCRETIA DAVID

MEDICARE: LUCRETIA DAVID
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
1175T00000XPeer SpecialistOR
2171M00000XCase Manager/Care CoordinatorOR

General Provider Information

NPI Number : 1912845991
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCRETIA DAVID
Provider Business Mailing Address
First Line : 115 N 10TH ST
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-5803
Country : US
Telephone Number : 541-882-2053
Fax Number :
Provider Business Practice Location Address
First Line : 115 N 10TH ST
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-5803
Country : US
Telephone Number : 541-882-2053
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “ LUCRETIA DAVID ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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