Provider Demographics
NPI:1942388467
Name:LUKK, HELLE EILEEN (MD)
Entity Type:Individual
Prefix:
First Name:HELLE
Middle Name:EILEEN
Last Name:LUKK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:714 S RUM RIVER DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MN
Mailing Address - Zip Code:55371-2224
Mailing Address - Country:US
Mailing Address - Phone:763-633-4325
Mailing Address - Fax:763-633-4326
Practice Address - Street 1:714 S RUM RIVER DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371-2224
Practice Address - Country:US
Practice Address - Phone:763-633-4325
Practice Address - Fax:763-633-4326
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN28175207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND83676Medicare UPIN