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1548626575
KEISHA PRUITT LUCKEY
JACKSON, MS
NPI
1548626575
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WD0400X Registered Nurse, Diabetes Educator
(Licence: MS R863378)
Enumeration Date
2016-01-06
Last Update Date
2016-01-06
Business Address
-- KEISHA PRUITT LUCKEY RN
2500 N STATE ST 2500 NORTH STATE STREET
JACKSON, MS 39216-4500
Phone number: 601-984-5682
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Mailing Address
-- KEISHA PRUITT LUCKEY RN
2254 WOODLAND PL
FLORENCE, MS 39073-9771
Phone number: 601-421-9291
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