Provider Demographics
NPI:1205559093
Name:NUCKOLLS, LYNSIE L'RAE (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:LYNSIE
Middle Name:L'RAE
Last Name:NUCKOLLS
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2215 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1105
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:9812 SLIDE RD
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-5781
Practice Address - Country:US
Practice Address - Phone:806-725-8765
Practice Address - Fax:806-725-8759
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1098296363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily