Provider Demographics
NPI:1245908607
Name:LUNCEFORD, CARA JOY (BSN, RN)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:JOY
Last Name:LUNCEFORD
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5723
Mailing Address - Country:US
Mailing Address - Phone:601-519-3985
Mailing Address - Fax:
Practice Address - Street 1:130 LONGWOOD DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5723
Practice Address - Country:US
Practice Address - Phone:601-519-3985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program