Provider Demographics
NPI:1477818425
Name:LUCHIE, JESSIE MAE
Entity Type:Individual
Prefix:MS
First Name:JESSIE
Middle Name:MAE
Last Name:LUCHIE
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 1:3105 28TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2093
Mailing Address - Country:US
Mailing Address - Phone:301-326-4607
Mailing Address - Fax:
Practice Address - Street 1:3105 28TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2093
Practice Address - Country:US
Practice Address - Phone:301-326-4607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide