Most Relevant Information
Provider Data
| NPI Number: | 1003696097 |
| Provider Name: | MAGEN BROOKE LUKE |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | GAA-NP001641 |
Most Important Dates
| Enumeration Date: | 10/05/2023 |
| Last Updated: | 10/05/2023 |
Provider Practice Location
3675 J DEWEY GRAY CIR STE 300
AUGUSTA
GA
309091868
Practice Location Phone/Fax
| Phone: | 7068639595 |
| Fax: | 7068688375 |
Provider Mailing Location
PO BOX 3726
AUGUSTA
GA
309143726
Provider Mailing Phone/Fax
| Phone: | 7068639595 |
| Fax: | 7068688375 |