Individual
MARIANA E LUCERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2132 N KANSAS AVE STE B, LIBERAL, KS 67901-2099
(620) 624-7400
(620) 624-7444
Mailing address
2132 N KANSAS AVE STE B, LIBERAL, KS 67901-2099
(620) 624-7400
(620) 624-7444
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0428884
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100222220A
—
OK
05
—
100379910C
—
KS
01
—
105320
BCBS PROVIDER #
KS
01
—
111218
BCBS GROUP #
KS
Enumeration date
03/15/2006
Last updated
06/05/2019
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