Individual provider Active NPI

Brooke D Lukasiewicz

  • Registered Nurse
  • Saint Paul, NE
National Provider Identifier
1740762632
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
64435 Issued in NE
Practice address
1113 Sherman St
Saint Paul, NE 68873-1546
Phone
(308) 754-4421
Fax
(308) 754-2303
NPI assigned
Sep 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 64435 NE Primary

Addresses

Primary practice location

1113 Sherman St
Saint Paul, NE 68873-1546

Mailing address

PO Box 406
Saint Paul, NE 68873-0406
Phone (308) 754-4421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
64435NEMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1740762632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688730406",
            "telephone_number": "308-754-4421",
            "fax_number": "308-754-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 SHERMAN ST",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688731546",
            "telephone_number": "308-754-4421",
            "fax_number": "308-754-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKASIEWICZ",
        "first_name": "BROOKE",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "64435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.