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Individual

DEBORAH CAROLINE LUCERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2310 PROVENANCE ST, LONGMONT, CO 80504-3706
(970) 402-5272
Mailing address
2310 PROVENANCE ST, LONGMONT, CO 80504-3706
(970) 402-5272

Taxonomy

Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
APN.0995488-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95-093-2243
DRIVER'S LICENSE
CO
Enumeration date
05/01/2020
Last updated
05/01/2020
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