Individual
MRS. KALLYN JEAN LUCERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3009 N SAGINAW RD, MIDLAND, MI 48640-4555
(989) 633-1350
(989) 633-1355
Mailing address
1180 N CLEAR LAKE RD, WEST BRANCH, MI 48661-9499
(989) 891-6840
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704286472
MI
Other
Enumeration date
01/11/2022
Last updated
10/25/2022
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