Provider Demographics
NPI:1770991804
Name:LUCAS, BOBBY GENE (FNP)
Entity type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:GENE
Last Name:LUCAS
Suffix:
Gender:M
Credentials:FNP
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Other - Credentials:
Mailing Address - Street 1:2517 7TH AVE S STE B2
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-3033
Mailing Address - Country:US
Mailing Address - Phone:406-952-0061
Mailing Address - Fax:855-570-2874
Practice Address - Street 1:2517 7TH AVE S STE B2
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-3033
Practice Address - Country:US
Practice Address - Phone:406-952-0061
Practice Address - Fax:855-570-2874
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-01
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT102840363LF0000X
GARN117999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily