Individual
SHANE LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-C
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 957-5711
Mailing address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 957-5711
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8241
CT
Other
Enumeration date
08/04/2019
Last updated
08/08/2019
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