Provider Demographics
NPI:1013588318
Name:LUHRS, KACY
Entity Type:Individual
Prefix:
First Name:KACY
Middle Name:
Last Name:LUHRS
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 1:9801 67TH AVE APT 6U
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4909
Mailing Address - Country:US
Mailing Address - Phone:516-462-1600
Mailing Address - Fax:
Practice Address - Street 1:110 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2787
Practice Address - Country:US
Practice Address - Phone:718-369-0817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY795034163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse