Individual provider · Type 1 NPI
Stephanie Marie Lee Luckanavanich, AG-ACNP
Acute Care Nurse Practitioner · Long Beach, CA
NPI number
1710749445
Active
Practice location
5901 E 7th St
Long Beach, CA 90822-5201
Mailing address
718 Red Sage
Irvine, CA 92618-1526
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Clinical Nurse Specialist | 364SG0600X | 95018256 (CA) |
| Acute Care Nurse Practitioner Primary | 363LA2100X | 95018256 (CA) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1710749445
Stephanie Marie Lee Luckanavanich, AG-ACNP's National Provider Identifier is 1710749445, issued on Jan 29, 2024. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Long Beach, CA. The record was last updated on Jan 29, 2024.