Provider Demographics
NPI:1124088950
Name:LUCAS, NANCY LOUISE (RN, RNFA)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LOUISE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:RN, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 RIDGE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-1718
Mailing Address - Country:US
Mailing Address - Phone:678-656-6819
Mailing Address - Fax:
Practice Address - Street 1:2311 RIDGE FOREST DR
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-1718
Practice Address - Country:US
Practice Address - Phone:678-656-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN056588163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant