| Doctor Name: | DR. SU CAROLYN SKJERSAA LUKINBEAL |
| NPI Number: | 1356590194 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, BS, D.MIN |
| License Number: | 000023424RN |
| Business Practice Address: | 389 E. Main Ave. Lower Back Door Sisters, OR - 97759 |
| Business Phone Number: | 5413178887 |
| Business Fax Number: | 5413178887 |
| Mailing Address: | 16356 Skyline Dr, BEND |
| State: | OR |
| Postal Code: | 977016947 |
| Phone Number: | 5413178887 |
| Fax Number: | 5413178887 |
| NPI Enumeration Date: | 09/17/2008 |
| NPI Last Update Date: | 09/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0000X |
| License Number: | 000023424RN |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pain Management |
| Taxonomy Definition: | |