Provider Demographics
NPI:1952774549
Name:LUCAS, CHERYL LYNN (ACNP-AG)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:LUCAS
Suffix:
Gender:F
Credentials:ACNP-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1100 W REYNOSA AVE
Mailing Address - Street 2:
Mailing Address - City:DE LEON
Mailing Address - State:TX
Mailing Address - Zip Code:76444-1630
Mailing Address - Country:US
Mailing Address - Phone:254-893-5895
Mailing Address - Fax:866-511-6662
Practice Address - Street 1:3804 HIGHWAY 377 S
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5120
Practice Address - Country:US
Practice Address - Phone:325-643-5167
Practice Address - Fax:866-247-6022
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP129550363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology