MS. CAROLYN M. LUCKETT (NPI# 1710126966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710126966 |
Entity Type | Individual |
Full Name | MS. CAROLYN M. LUCKETT |
Credential | NP |
Practice Address |
2000 Circle of Hope Dr Clinic 2d Salt Lake City UT 84112-5550 |
Mailing Address |
127 S 500 E Ste 600 Salt Lake City UT 84102-1971 |
Practice Telephone | 8015850100 |
Practice Fax Number | 8015817381 |
Mailing Telephone | (801) 587-6705 |
Mailing Fax Number | 8017158228 |
Enumeration Date | 2009-02-11 |
Last Update Date | 2017-09-27 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
220048-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2000 CIRCLE OF HOPE DR CLINIC 2D |
City | SALT LAKE CITY |
State | UT |
Zip Code | 84112-5550 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699775767 | Sunil Sharma | Internal Medicine | 2000 Circle of Hope Dr, #3380, Salt Lake City, UT 84112-5550 | 2005-07-29 |
1124638812 | Youngbeen Jeon Shamo | Nurse Practitioner | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2020-08-06 |
1760091359 | Samantha Jean Powell | Social Worker | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2020-07-29 |
1760035174 | Nidhi Sharma | Nurse Practitioner | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2019-07-24 |
1356901003 | Cassie Kuhn | Nurse Practitioner | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2019-06-15 |
1134788623 | Ambreen Khan | Genetic Counselor, MS | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2019-06-10 |
1558920835 | Jace Dakota Johnny | Nurse Practitioner | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2019-06-10 |
1548738826 | Yelena Ping Wu | Psychologist | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2018-11-05 |
1902380058 | Emily Catherine Armstrong | Physician Assistant | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2018-09-24 |
1467934398 | Alexandra Suzanne Locke | Physician Assistant | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2018-09-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508484023 | Courtney Hook | Student in an Organized Health Care Education/Training Program | 1860 E 250 S Hper East, Room 208, Salt Lake City, UT 84112 | 2020-07-10 |
1235792839 | Dylan Lamb | Rehabilitation Practitioner | 1850 S. 260 E, Salt Lake City, UT 84112 | 2019-04-18 |
1740787407 | David Bradley Patch | Student in an Organized Health Care Education/Training Program | University of Utah Hospital Dental Clinic #7, 50 N. Medical Dr., Salt Lake City, UT 84112 | 2018-04-10 |
1962949586 | Gina Whitehead | Nurse Practitioner | 10 South 2000 East, Salt Lake City, UT 84112 | 2017-01-20 |
1316493117 | Dana Friske | Specialist/Technologist | 290 S 1850 E, Room 103, Salt Lake City, UT 84112 | 2016-08-31 |
1548612435 | Frances Millett Johnson | Nurse Practitioner | 555 South Foothill Blvd, Suite 301, Salt Lake City, UT 84112 | 2016-07-05 |
1679920904 | Jason Lippman | Family Medicine | 555 S. Foothill Blvd., Ste. 301, Salt Lake City, UT 84112 | 2016-05-17 |
1447604335 | Joseph Mcbeth | Specialist/Technologist | 580 S. Guardsman Way, Salt Lake City, UT 84112 | 2016-04-18 |
1104213636 | Cameron Critchfield | Student in an Organized Health Care Education/Training Program | 26 South 2000 East, Suite 5900, Salt Lake City, UT 84112 | 2015-04-22 |
1942697933 | Jennifer Rose | Dentist | 50 N Medical Dr, University Hospital, Salt Lake City, UT 84112 | 2015-04-17 |
Find all providers in zip 84112 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982204590 | Gabrielle Sleater Lewis | Nurse Practitioner | 2905 S Mcclelland St, Salt Lake City, UT 84106-2125 | 2020-11-01 |
1962019596 | Freya Kristen Landesman | Nurse Practitioner | 60 E South Temple Ste 300, Salt Lake City, UT 84111-1041 | 2020-09-28 |
1568075604 | Michelle L Davis | Nurse Practitioner | 24 S 1100 E Ste 305, Salt Lake City, UT 84102-4500 | 2020-08-28 |
1518583988 | Melanie Elise Harris | Nurse Practitioner | 1250 E 3900 S Ste 301, Salt Lake City, UT 84124-1350 | 2020-06-22 |
1295359651 | Julie Nielsen | Nurse Practitioner | 1170 E Westminster Ave Apt C, Salt Lake City, UT 84105-3514 | 2020-06-02 |
1770112138 | Justin Henderson | Nurse Practitioner | 3851 S Birch Dr, Salt Lake City, UT 84109-3742 | 2020-04-07 |
1346885845 | Anita Hui Lucente | Nurse Practitioner | 1111 E Brickyard Rd, Salt Lake City, UT 84106-2560 | 2019-11-08 |
1841844057 | Mayra Ibeth Vences | Nurse Practitioner | 1146 N Antilles Dr, Salt Lake City, UT 84116-4656 | 2019-07-25 |
1710549928 | Jenny Farley Mason | Nurse Practitioner | 4179 S Monarch Way, Salt Lake City, UT 84124-3168 | 2019-07-08 |
1144889940 | Amy Jackson Gilbert | Nurse Practitioner | 1950 Circle of Hope Dr Rm 4146, Salt Lake City, UT 84112-5500 | 2019-06-06 |
Find all providers in SALT LAKE CITY |
City | SALT LAKE CITY |
Zip Code | 84112 |
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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.