Mary M Luciani

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

4704394196 Issued in MI

Practice address

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Phone

(317) 828-3956

NPI assigned

Sep 15, 2023

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1750169439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9053 HEARTHSTONE DR",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460775514",
            "telephone_number": "317-828-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "317-828-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIANI",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MI",
            "license": "4704394196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Lucero
• Lucey Chiropractic and Wellness Center
• Benjamin Fredrick Lucey, DC
• Nora Mei Luchs, LMSW
• Martin Luchtefeld, MD
• Alison Meredith Luck
• Amber Luckett
• Donna Lee Luckett
• Roneidra Dionne-Hill Lucky, MSN, CNM
• Kelly D. Ludema, D.O.

• All providers in Grand Rapids, MI
• Adult Health Clinical Nurse Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.