Provider Demographics
NPI:1730671140
Name:LUCAS, WILLIAM GENE (FNP-C)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GENE
Last Name:LUCAS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1220
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-1220
Mailing Address - Country:US
Mailing Address - Phone:520-449-7896
Mailing Address - Fax:
Practice Address - Street 1:16680 S AVENIDA TRES
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-6781
Practice Address - Country:US
Practice Address - Phone:520-449-7896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily