Individual
MRS. NISSA BREANN LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
415 N MAIN ST, SPANISH FORK, UT 84660-1439
(801) 798-9700
(801) 798-3131
Mailing address
415 N MAIN ST, SPANISH FORK, UT 84660-1439
(801) 798-9700
(801) 798-3131
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
64501484405
UT
Other
Enumeration date
02/14/2011
Last updated
02/14/2011
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