Jennafer Luckey, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R206616 Issued in MD

Practice address

4200 Altamont PL
White Plains, MD 20695-3052

Phone

(301) 645-2774

NPI assigned

Nov 13, 2016

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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1478995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1881136554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 GARDEN LN",
            "city": "BRYANS ROAD",
            "state": "MD",
            "postal_code": "206163258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 ALTAMONT PL",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953052",
            "telephone_number": "301-645-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKEY",
        "first_name": "JENNAFER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-13",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R206616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birgit J Locklear, LSCW-C
• Ryan Look, DMD
• Dayaneth Yolanda Lopez
• Love N Care Home Healthcare LLC
• Amber Denise Luck, CRNP
• Lung & Sleep Institute LLC
• Kristi Bengtson Machemer, M.D.
• Alesia L Madden, DPM
• Jojo Arroll Lacerna Manato, D.D.S.
• Sophia Marchionini

• Family Nurse Practitioner in White Plains, MD
• Providers in White Plains, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.