Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TIMOTHY PRYOR LUCKETT, REGISTERED NURSE
Active Sole ProprietorMR. TIMOTHY PRYOR LUCKETT, REGISTERED NURSE is a Registered Nurse First Assistant healthcare provider located in RANCHO CUCAMONGA, California. NPI 1629266028 is currently active in the NPPES registry. Verify at CMS.
Registered Nurse First Assistant · RANCHO CUCAMONGA, CA
Registration Details
- NPI Number
- 1629266028
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 10, 2007 (18.879515863201 yrs)
- Last Updated
- Oct 10, 2007
- License
-
RN290090 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
14171 SHEPHERD DRRANCHO CUCAMONGA, CA, 917392215Browse CA providers · Browse ZIP 91739
- Phone
- 9092682126
- Fax
- 9098998850
- Primary Specialty
-
Registered Nurse First Assistant
163WR0006X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.