Lukasiewicz, Gail S
Lukasiewicz, Gail S is an individual health care provider with primary practice located at 610 N Michigan St Suite 400, South Bend IN 46601-1077. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lukasiewicz, Gail S can be contacted via phone (574) 647-8120.Contact Information
Primary practice address
610 N Michigan St Suite 400
South Bend IN 46601-1077
Phone: (574) 647-8120
Fax: (574) 647-8111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71001252A | Indiana |
Profile Details
| NPI number | 1104816479 |
|---|---|
| LBN Legal business name | Lukasiewicz, Gail S |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Feb 19th, 2009 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104816479 | NPPES |
| Indiana | Other | 257270B | MEDICARE PTAN |
| Indiana | MEDICAID | 200411050 | MEDICARE PTAN |
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