Provider Demographics
NPI:1013704436
Name:STEPHANIE LUCAS APRN LLC
Entity type:Organization
Organization Name:STEPHANIE LUCAS APRN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:270-903-7100
Mailing Address - Street 1:9275 S HIGHWAY 261
Mailing Address - Street 2:
Mailing Address - City:FALLS OF ROUGH
Mailing Address - State:KY
Mailing Address - Zip Code:40119-4121
Mailing Address - Country:US
Mailing Address - Phone:270-903-7100
Mailing Address - Fax:
Practice Address - Street 1:9275 S HIGHWAY 261
Practice Address - Street 2:
Practice Address - City:FALLS OF ROUGH
Practice Address - State:KY
Practice Address - Zip Code:40119-4121
Practice Address - Country:US
Practice Address - Phone:270-903-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty