Provider Demographics
NPI:1063221745
Name:LUKAS, LEANNA MARIE
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:MARIE
Last Name:LUKAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5926
Mailing Address - Country:US
Mailing Address - Phone:402-831-0908
Mailing Address - Fax:
Practice Address - Street 1:621 S LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5926
Practice Address - Country:US
Practice Address - Phone:402-831-0908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor