MR. GILBERT LYNN LUCKEL AG-ACNP NPI 1275934580

NPI Information

NPI: 1275934580
Provider Name: MR. GILBERT LYNN LUCKEL, AG-ACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
101 COURTENAY CIR
HATTIESBURG, MS
ZIP 39402
Phone: (601) 579-5180
Get Directions

MR. Gilbert Lynn Luckel, AG-ACNP is an acute care nurse practitioner in Hattiesburg, MS with 10 years of experience. MR. Gilbert Lynn Luckel, AG-ACNP NPI is 1275934580. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

101 COURTENAY CIR
HATTIESBURG, MS
ZIP 39402-176
Phone: (601) 579-5180
Fax: (601) 579-5374

The NPI 1275934580 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/6/2014 and was last updated on 7/24/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		R884250	MISSISSIPPI	No
2	363LA2100X	Nurse Practitioner	Acute Care	R884250	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01001724	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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