| Doctor Name: | JENNIFER FOWLER LUCAS |
| NPI Number: | 1104241678 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 0110004450 |
| Business Practice Address: | 20306 Badger Lane Onley, VA - 234180159 |
| Business Phone Number: | 7577877374 |
| Business Fax Number: | 7577874513 |
| Mailing Address: | Po Box 159, ONLEY |
| State: | VA |
| Postal Code: | 234180159 |
| Phone Number: | 7577877374 |
| Fax Number: | |
| NPI Enumeration Date: | 02/20/2014 |
| NPI Last Update Date: | 12/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0110004450 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |