Lueck, Kelly J

Lueck, Kelly J is an sole proprietor health care provider with primary practice located at 2946 E Banner Gateway Dr , Gilbert AZ 85234-2165. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Lueck, Kelly J can be contacted via phone (480) 256-6444.

Contact Information

Primary practice address
2946 E Banner Gateway Dr Gilbert AZ 85234-2165
Phone: (480) 256-6444
Fax: (480) 256-3682
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X TAP4690 Arizona
Allopathic & Osteopathic Physicians / General Practice 208D00000X 201610216NP-PP Oregon
Allopathic & Osteopathic Physicians / General Practice 208D00000X TAP4690 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X TAP4690 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 201610216NP-PP Oregon

Profile Details

NPI number 1578815809
LBN Legal business name Lueck, Kelly J
Credentials FNP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 10th, 2012
Last updated Feb 8th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578815809 NPPES
Oregon MEDICAID 500729417

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