Provider Demographics
NPI:1134224769
Name:LUCAS, ANNE M (MSN, CNP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MSN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10315 BRIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:BRATENAHL
Mailing Address - State:OH
Mailing Address - Zip Code:44108-1029
Mailing Address - Country:US
Mailing Address - Phone:216-761-0965
Mailing Address - Fax:216-844-2064
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:BHC 5055
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-2601
Practice Address - Fax:216-844-2064
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-03396363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care