Provider Demographics
NPI:1033579933
Name:CLICKCARE, LLC
Entity Type:Organization
Organization Name:CLICKCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATNENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUSTER-TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:901-288-5200
Mailing Address - Street 1:117 AUTUMN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:117 AUTUMN CREEK DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-3603
Practice Address - Country:US
Practice Address - Phone:901-288-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05600363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty