Individual
CELINA M LUCHETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
490A W ZIA RD, SUITE 200, SANTA FE, NM 87505-6996
(505) 988-3975
(505) 986-8001
Mailing address
455 SAINT MICHAELS DR, SANTA FE, NM 87505-7601
(505) 802-5227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2003-0030
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10012822
LOVELACE
—
05
—
22537082
—
NM
01
—
PROVP14189
MOLINA
—
Enumeration date
05/26/2006
Last updated
12/11/2007
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