Aubrey Kay Lucas, RN
Individual provider Active NPI Registered Nurse · Gladewater, TX
NPI 1306468079 · NPPES record last updated May 15, 2020
Key facts
- NPI
- 1306468079
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 967236 (TX)
- Practice address
- 1308 N Rodeo St
Gladewater, TX 75647-4058 - Phone
- (903) 399-9149
- NPI assigned
- May 15, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 967236 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 967236 | TX | Yes |
Addresses
Primary practice location
1308 N Rodeo St
Gladewater, TX 75647-4058
Mailing address
1308 N Rodeo St
Gladewater, TX 75647-4058
Other providers in Gladewater, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.