Provider Demographics
NPI:1487244646
Name:LUKES-MILLEDGE, RICHINA J (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RICHINA
Middle Name:J
Last Name:LUKES-MILLEDGE
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Gender:F
Credentials:AGPCNP-BC
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Mailing Address - Street 1:273 WALT WHITMAN RD STE 190
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4149
Mailing Address - Country:US
Mailing Address - Phone:917-337-3788
Mailing Address - Fax:631-824-9039
Practice Address - Street 1:506B WALT WHITMAN RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2109
Practice Address - Country:US
Practice Address - Phone:631-824-6648
Practice Address - Fax:631-824-9039
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT9442363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology