Provider Demographics
NPI:1194047829
Name:DRANE, LUCINDA BOSWELL (APRN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:BOSWELL
Last Name:DRANE
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 HIGHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-4635
Mailing Address - Country:US
Mailing Address - Phone:601-445-0740
Mailing Address - Fax:601-897-4210
Practice Address - Street 1:329 HIGHLAND BLVD
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4635
Practice Address - Country:US
Practice Address - Phone:601-445-0740
Practice Address - Fax:601-897-4210
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN124893-AP05859363LF0000X
MSR874307363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2351788Medicaid
MS01526357Medicaid
LA2351788Medicaid
KY50031989OtherPASSORT SPECIALTY- FOUNDATION
KYP400038218Medicare PIN
KY7100156820Medicaid