Provider Demographics
NPI:1972888253
Name:LUCK, VALERIE LYNN (RN, MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:LUCK
Suffix:
Gender:F
Credentials:RN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 E LA DONNA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2447
Mailing Address - Country:US
Mailing Address - Phone:480-390-1716
Mailing Address - Fax:
Practice Address - Street 1:10200 N 92ND ST
Practice Address - Street 2:MEDICAL PLAZA BUILDING 4, SUITE 140
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4534
Practice Address - Country:US
Practice Address - Phone:480-390-1716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP4140OtherSTATE OF ARIZONA BOARD OF NURSING