Provider Demographics
NPI:1235992587
Name:LUCAS, KATHERINE BROOKS
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:BROOKS
Last Name:LUCAS
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 1:1962 BRANTLEY CIR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2900
Mailing Address - Country:US
Mailing Address - Phone:352-223-2565
Mailing Address - Fax:
Practice Address - Street 1:1962 BRANTLEY CIR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2900
Practice Address - Country:US
Practice Address - Phone:352-223-2565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program