Provider Demographics
NPI:1316809106
Name:LUKWAGO, HENRY K (MSN-AGPCNP RN)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:K
Last Name:LUKWAGO
Suffix:
Gender:M
Credentials:MSN-AGPCNP RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 SENTINEL RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-5662
Mailing Address - Country:US
Mailing Address - Phone:240-547-7651
Mailing Address - Fax:540-720-1006
Practice Address - Street 1:155 SENTINEL RIDGE LN
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-5662
Practice Address - Country:US
Practice Address - Phone:240-547-7651
Practice Address - Fax:540-720-1006
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001269525163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty