Lucas, Antonette

Lucas, Antonette is an individual health care provider with primary practice located at 136 E Ash St , Jackson MS 39202-2217. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Lucas, Antonette can be contacted via phone (601) 352-6507.

Contact Information

Primary practice address
136 E Ash St Jackson MS 39202-2217
Phone: (601) 352-6507
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R860519 Mississippi

Profile Details

NPI number 1699735803
LBN Legal business name Lucas, Antonette
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Mar 26th, 2010 - about 15 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699735803 NPPES
Mississippi Other 253418 MEDICARE RURAL HEALTH
Mississippi MEDICAID 04535731 MEDICARE RURAL HEALTH

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