Provider Demographics
NPI:1396889895
Name:LUKE, ANN MARIE (RN PHN FNP)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:LUKE
Suffix:
Gender:F
Credentials:RN PHN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 REBECCA ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51103-2433
Mailing Address - Country:US
Mailing Address - Phone:707-391-6903
Mailing Address - Fax:
Practice Address - Street 1:1 BLUE BUNNY DR SW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-2207
Practice Address - Country:US
Practice Address - Phone:712-966-7200
Practice Address - Fax:855-547-6073
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374579163WC1500X
CA11617363LF0000X
IAA176073363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily