| Doctor Name: | JEANNE LOUISE LUCK |
| NPI Number: | 1093733768 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, MSN, CFNP |
| License Number: | R105398-8 |
| Business Practice Address: | 8290 University Ave Ne Suite 200 Fridley, MN - 554321847 |
| Business Phone Number: | 7637869543 |
| Business Fax Number: | 7637863320 |
| Mailing Address: | 6465 Wayzata Blvd, Suite 900 ST LOUIS PARK |
| State: | MN |
| Postal Code: | 554261728 |
| Phone Number: | 9525125600 |
| Fax Number: | 9525125650 |
| NPI Enumeration Date: | 07/18/2006 |
| NPI Last Update Date: | 07/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R105398-8 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |