Provider Demographics
NPI:1982265393
Name:LUCAS, GENEVA V
Entity type:Individual
Prefix:
First Name:GENEVA
Middle Name:V
Last Name:LUCAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N CAPITOL ST NW APT B612
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7533
Mailing Address - Country:US
Mailing Address - Phone:202-468-9508
Mailing Address - Fax:
Practice Address - Street 1:1200 N CAPITOL ST NW APT B612
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7533
Practice Address - Country:US
Practice Address - Phone:202-468-9508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide