Lucia Ann-Rebecca Clark, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Lowell, IN
NPI 1013885847 · NPPES record last updated Oct 24, 2025
Key facts
- NPI
- 1013885847
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F10250500 (IN)
- Practice address
- 17584 Mississippi St
Lowell, IN 46356-9794 - Phone
- (219) 252-5862
- NPI assigned
- Oct 24, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
17584 Mississippi St
Lowell, IN 46356-9794
55 E 86TH Ave
Suite Candd
Merrillville, IN 46410-6382
7465 E Osborn Rd
Scottsdale, AZ 85251-6590
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260505003205 | IN | Practitioner - Nurse Practitioner | 6507952348 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F10250500 | IN | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F10250500 | IN | Yes |
Addresses
Primary practice location
17584 Mississippi St
Lowell, IN 46356-9794
Mailing address
17584 Mississippi St
Lowell, IN 46356-9794
Phone (219) 252-5862
Other providers in Lowell, IN
- Steven Joseph Butera
- Kelly Ann Calvillo
- Kelley Campbell
- Kathryn Camus
- Anastasia Christakis-Szostek
- Paul K Clark
- David W Conaway
- Rhonda Sue Courtright
- Susan Marie Cummings
- Joshua Nathaniel Degood
All providers in Lowell, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.