Provider Demographics
NPI:1548600653
Name:LUCIUS, AMY E (CNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:LUCIUS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10730 NALL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1242
Mailing Address - Country:US
Mailing Address - Phone:913-754-2800
Mailing Address - Fax:913-754-2899
Practice Address - Street 1:10730 NALL AVE STE 101
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1242
Practice Address - Country:US
Practice Address - Phone:913-754-2800
Practice Address - Fax:913-754-2899
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2013021221363L00000X
KS53-75901-032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner