| NPI | 1750706826 |
|---|---|
| Former Name | NICOLE L LUCZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704296871) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704296871) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2023-02-02 |