Provider Demographics
NPI:1700473873
Name:LUTZ, LINDA KAY
Entity type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:KAY
Last Name:LUTZ
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 1:404 W CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-2125
Mailing Address - Country:US
Mailing Address - Phone:419-561-1427
Mailing Address - Fax:
Practice Address - Street 1:404 W CHARLES ST
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-2125
Practice Address - Country:US
Practice Address - Phone:419-561-1427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide