Elizabeth Anne Lucas, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704211535 Issued in MI

Practice address

17141 Ryan Rd
Detroit, MI 48212-1112

Phone

(313) 369-1717

NPI assigned

Feb 19, 2010

Last updated

Sep 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Elizabeth Anne Peabody Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1871815712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17141 RYAN RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121112",
            "telephone_number": "313-369-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17141 RYAN RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121112",
            "telephone_number": "313-369-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704211535",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704211535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PEABODY",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "MSN, RN, PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laval Alonzo Lucas-Perry, RDH
• Victoria Monique Lucas-Perry, DDS
• Charles Edward Lucas, MD
• Cheryl Lucas, LMSW
• Ebony Sukarie-Leatrice Lucas, LLMSW
• Hannah Lucas
• Janice Lucas
• Jessica L Lucas, DO
• Kerrie Ann-Marie Lucas, NURSE PRACTITIONER
• Maurice W Lucas Jr.

• Psychiatric/Mental Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.