Provider Demographics
NPI:1184893521
Name:LUCKEY-PERCY, ALISON L (APRN)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:L
Last Name:LUCKEY-PERCY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-5501
Mailing Address - Country:US
Mailing Address - Phone:860-679-6700
Mailing Address - Fax:860-679-6706
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-5501
Practice Address - Country:US
Practice Address - Phone:860-679-6700
Practice Address - Fax:860-679-6706
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003782363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT030782OtherCONNECTICARE
CT06-1406459OtherGREAT WEST HEALTHCARE
CT06-1406459OtherNORTHEAST HEALTH DIRECT
CT06-1406459OtherCOMMUNITY HEALTH NETWORK
CT400003782CT01OtherANTHEM BCBS OF CT
CT06-1406459OtherMULTIPLAN
CT06-1406459OtherPIONEER
CT06-1406459OtherWELLCARE
CT06-1406459OtherPRIVATE HEALTHCARE SYSTEMS
CT3V4760OtherHEALTH NET
CT06-1406459OtherTRICARE
CT06-1406459OtherMULTIPLAN