Individual provider · NPI-1

Mary M Luciani

Clinical Nurse Specialist, Adult Health · Grand Rapids, MI

NPI number1750169439
StatusActive
Last updated in NPPESSep 15, 2023

Details

NPI
1750169439
Entity type
Individual (NPI-1)
Name
Mrs. Mary M Luciani
Sex
Female
Sole proprietor
No
Enumeration date
Sep 15, 2023
Certification date
Nov 14, 2022
Last updated
Sep 15, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
364SA2200X Clinical Nurse Specialist, Adult Health4704394196MIYes

Practice location

200 Jefferson Ave Se
Grand Rapids, MI 49503-4502

Phone 317-828-3956

Mailing address

9053 Hearthstone Dr
Zionsville, IN 46077-5514

Phone 317-828-3956

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