Provider Demographics
NPI:1427871466
Name:LUCAS, DAVID JOSEPH (MSN, RN, AGACNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:LUCAS
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Gender:
Credentials:MSN, RN, AGACNP
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Other - Middle Name:
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Mailing Address - Street 1:4410 SILSBY RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0038566363LC0200X
OHRN.453265163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience