Provider Demographics
NPI:1013525716
Name:LUKE, JOSHUA J (FNP-C)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:J
Last Name:LUKE
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 1:329 KLEINPETER DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-7821
Mailing Address - Country:US
Mailing Address - Phone:985-991-0222
Mailing Address - Fax:
Practice Address - Street 1:113 BELLE TERRE BLVD
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3349
Practice Address - Country:US
Practice Address - Phone:985-359-2273
Practice Address - Fax:985-359-8560
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-19
Last Update Date:2020-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA213965363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner