Provider Demographics
NPI:1255624664
Name:LUKEY, BRIANNA ELIZABETH
Entity type:Individual
Prefix:MS
First Name:BRIANNA
Middle Name:ELIZABETH
Last Name:LUKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3543 TATES CREEK RD APT 112
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-2646
Mailing Address - Country:US
Mailing Address - Phone:410-652-7815
Mailing Address - Fax:855-871-1240
Practice Address - Street 1:3543 TATES CREEK RD APT 112
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-2646
Practice Address - Country:US
Practice Address - Phone:410-652-7815
Practice Address - Fax:855-871-1240
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist