| NPI | 1811643315 | 
|---|---|
| Former Name | CHERYL MARIE LUCAS | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209024769)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.024769)  | 
| Enumeration Date | 2022-02-23 | 
| Last Update Date | 2024-06-12 |