| Doctor Name: | ANGELA JEAN LUCKOW |
| NPI Number: | 1174775506 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 162885-030 |
| Business Practice Address: | 1981 Greengrove St Kaukauna, WI - 541303921 |
| Business Phone Number: | 9207594436 |
| Business Fax Number: | |
| Mailing Address: | 3120 Tri Park Ct Apt 5, APPLETON |
| State: | WI |
| Postal Code: | 549146422 |
| Phone Number: | 9207402191 |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2008 |
| NPI Last Update Date: | 10/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 162885-030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |