Provider Demographics
NPI:1952847725
Name:LUKEHART, VERNA (RD,RN)
Entity Type:Individual
Prefix:MRS
First Name:VERNA
Middle Name:
Last Name:LUKEHART
Suffix:
Gender:F
Credentials:RD,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 LASALLE RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2322
Mailing Address - Country:US
Mailing Address - Phone:860-906-1289
Mailing Address - Fax:860-906-1269
Practice Address - Street 1:125 LASALLE RD
Practice Address - Street 2:SUITE 208
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2322
Practice Address - Country:US
Practice Address - Phone:860-906-1289
Practice Address - Fax:860-906-1269
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001475133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered