Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justice Nicole Luttrell, PA

Individual provider Physician Assistant · NPI 1265166797

Justice Nicole Luttrell, PA is a Physician Assistant in Lakeview, Michigan. Qualified in 2022, 4 years ago. Practices with Spectrum Health United, a 88-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
4
Licensed in
MI
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

8650 Howard City Edmore Rd
Lakeview, MI 48850-7102
Phone: (989) 352-6474
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601011239 (MI)

Record details

NPI number1265166797
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 11, 2022
Last updated in NPPESJune 26, 2023
Certification dateJune 26, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Spectrum Health United — 88 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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