Provider Demographics
NPI:1619740511
Name:LUCIEN, MARIE MADELEINE (APRN PMHNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:MADELEINE
Last Name:LUCIEN
Suffix:
Gender:F
Credentials:APRN PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 N 31ST RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5514
Mailing Address - Country:US
Mailing Address - Phone:954-258-4828
Mailing Address - Fax:
Practice Address - Street 1:929 N 31ST RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5514
Practice Address - Country:US
Practice Address - Phone:954-258-4828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL110294512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry