Provider Demographics
NPI:1508613274
Name:LUCAS, TAMAR JONES (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:TAMAR
Middle Name:JONES
Last Name:LUCAS
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 BENSON JONES RD
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MS
Mailing Address - Zip Code:38843
Mailing Address - Country:US
Mailing Address - Phone:662-322-1818
Mailing Address - Fax:833-707-1951
Practice Address - Street 1:609 BRUNSON DR STE B
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4948
Practice Address - Country:US
Practice Address - Phone:662-322-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906644363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health