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1164705042
KIMBERLY LUCAITIS
GARY, IN
NPI
1164705042
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Former Name
KIMBERLY GOODRICH
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IN 28141967A)
Enumeration Date
2011-09-27
Last Update Date
2016-11-18
Business Address
-- KIMBERLY LUCAITIS FNP
600 GRANT ST
GARY, IN 46402-6001
Phone number: 219-886-4464
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Mailing Address
-- KIMBERLY LUCAITIS FNP
600 GRANT ST
GARY, IN 46402-6001
Phone number: 219-886-4464
Copy
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