Kukucka, Gerri
Kukucka, Gerri is an individual health care provider with primary practice located at 5224 Sunset Blvd , Lexington SC 29072-9259. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kukucka, Gerri can be contacted via phone (803) 796-4251.Contact Information
Primary practice address
5224 Sunset Blvd
Lexington SC 29072-9259
Phone: (803) 796-4251
Fax: (803) 796-4449
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 24208 | South Carolina |
Profile Details
| NPI number | 1740888262 |
|---|---|
| LBN Legal business name | Kukucka, Gerri |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2020 |
| Last updated | Jan 2nd, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740888262 | NPPES |
| South Carolina | MEDICAID | NP8155 |
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