MR. TIMOTHY PRYOR LUCKETT (NPI# 1629266028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629266028 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY PRYOR LUCKETT |
| Credential | REGISTERED NURSE |
| Practice Address |
14171 Shepherd Dr Rancho Cucamonga CA 91739-2215 |
| Practice Telephone | 9092682126 |
| Practice Fax Number | 9098998850 |
| Mailing Telephone | 9092682126 |
| Mailing Fax Number | 9098998850 |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2007-10-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WR0006X |
Registered Nurse Specialization: Registered Nurse First Assistant |
RN290090 | CA | Nursing Service Providers |
| Street Address |
14171 SHEPHERD DR |
| City | RANCHO CUCAMONGA |
| State | CA |
| Zip Code | 91739-2215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699230300 | Gogo Medical Transport Inc. | Non-emergency Medical Transport (VAN) | 13269 Firestone Dr, Rancho Cucamonga, CA 91739 | 2019-02-06 |
| 1306348768 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 7210 Day Creek Blvd, Suite 110, Rancho Cucamonga, CA 91739 | 2018-03-01 |
| 1770082141 | Rajnis Jasani | Pharmacist | 7777-b Milliken Ave, Ste 100, Rancho Cucamonga, CA 91739 | 2018-02-12 |
| 1548787542 | Carla Hibet Castillo | Counselor | 7165 Etiwanda Ave, Rancho Cucamonga, CA 91739 | 2017-08-29 |
| 1598282428 | Yung Chun Chen | Dentist | 12453 Royal Oaks Dr., Montclair, CA 91739 | 2017-08-22 |
| 1508386806 | Emily Rose Marlen | Counselor | 845 E. Arrow Highway, Pomona, CA 91739 | 2017-06-27 |
| 1124384540 | Ameerah Rasheedah-bonner Mcmann | Marriage & Family Therapist | 8481 Etiwanda Avenue, Apartment G, Rancho Cucamonga, CA 91739 | 2012-04-10 |
| 1679866784 | Bodylogics Health Services Inc. | Rehabilitation Practitioner | 12730 Foothill Blvd., Unit 102, Rancho Cucamonga, CA 91739 | 2011-05-23 |
| 1801196027 | Lisa Louise Hazelwood | Psychologist | 9500 Etiwanda Ave., West Valley Detention Center, Attn: Medical Srvcs/liberty Roc, Rancho Cucamonga, CA 91739 | 2010-10-22 |
| 1700023520 | Gideon Puiyuen Kwok | Legal Medicine | 12225 Foothill Blvd #120, Rancho Cucamonga, CA 91739 | 2009-01-15 |
| Find all providers in zip 91739 | ||||
| Taxonomy Code | 163WR0006X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Registered Nurse First Assistant |
| A perioperative registered nurse who works in collaboration with the surgeon and other health care team members to achieve optimal outcomes. The RNFA has acquired the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice. Intraoperatively, the RNFA assists the surgeon. |
| Notes: Source: AORN Official Statement on RNFAs ratified by the AORN House of Delegates in 2004. [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760006514 | Rudhel Agtang Baniaga | Registered Nurse | 401 E Wren Ave, Visalia, CA 93291-2103 | 2020-06-07 |
| 1306492541 | Sinath Prom | Registered Nurse | 1642 Trieste Ct, San Jose, CA 95122-3833 | 2019-08-14 |
| 1467014142 | Amber Michelle Packer | Registered Nurse | 22 Corporate Plaza Dr Ste 150, Newport Beach, CA 92660-7999 | 2019-07-02 |
| 1861056194 | Dean A Hopkins Cnor Rnfa | Registered Nurse | 1643 Palatia Dr, Roseville, CA 95661-7751 | 2019-04-22 |
| 1841758075 | Christine Andres Jose | Registered Nurse | 5341 Aspen St, Dublin, CA 94568-7676 | 2019-03-06 |
| 1215406996 | Alfredo Pastor | Registered Nurse | 9510 Lake Superior Dr, Bakersfield, CA 93312-6246 | 2018-11-25 |
| 1457839953 | Gabriel Valdez Perez | Registered Nurse | 38 Terrace Dr, Concord, CA 94518-2045 | 2018-08-06 |
| 1639660483 | Shelly Lynn Hill | Registered Nurse | 7050 N Recreation Ave Ste 103, Fresno, CA 93720-8001 | 2018-05-27 |
| 1518455765 | Harjet Kaur | Registered Nurse | 12064 Roswell Ave, Chino, CA 91710-1550 | 2018-04-24 |
| 1972091270 | Staci Ann Mckee | Registered Nurse | 1559 Beacon Ridge Way, Corona, CA 92883-0726 | 2018-04-23 |
| Find all providers with the same taxonomy | ||||
| City | RANCHO CUCAMONGA |
| Zip Code | 91739 |
Please comment or provide details below to improve the information on MR. TIMOTHY PRYOR LUCKETT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.