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NPI Profile for LAKESHA LUCKETT in OAK CREEK, WI.
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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Medicine |
207QA0505X | 08 | Physician/Family Practice |
| NPI # | 1063223626 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 01/14/2025 | |
| Last updated | 01/14/2025 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LAKESHA LUCKETT
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LAKESHA LUCKETT