Provider Demographics
NPI:1184260028
Name:LUECKE, CHRISTOPHER NORMAN (ARNP)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:NORMAN
Last Name:LUECKE
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 FORBES TRCE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-2903
Mailing Address - Country:US
Mailing Address - Phone:727-946-3294
Mailing Address - Fax:
Practice Address - Street 1:3251 N MCMULLEN BOOTH RD STE 303
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2022
Practice Address - Country:US
Practice Address - Phone:727-725-6110
Practice Address - Fax:727-725-5561
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily