Keisha Pruitt Luckey, RN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

R863378 Issued in MS

Practice address

2500 N State St
2500 North State Street
Jackson, MS 39216-4500

Phone

(601) 984-5682

Fax

(601) 815-3672

NPI assigned

Jan 6, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1548626575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2254 WOODLAND PL",
            "city": "FLORENCE",
            "state": "MS",
            "postal_code": "390739771",
            "telephone_number": "601-421-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "address_2": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5682",
            "fax_number": "601-815-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "KEISHA",
        "middle_name": "PRUITT",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "MS",
            "license": "R863378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keianna Renae Luckett, DNP, AGACNP-BC
• Mary Luckett
• Shakita Moneka Luckett
• Tiana Luckett
• Willeta Luckett, PHARMD
• Margarita Luckhardt, MD
• Lauren Ludwig, DMD
• Elizabeth Luker
• Reginald Lumpkin
• Emilio Miguel Luna-Suarez, MD

• Diabetes Educator Registered Nurse in Jackson, MS
• Providers in Jackson, MS by specialty
• Diabetes Educator Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.