MEDICARE: LUCIA GABRIELA BOTTS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WM0705X	Medical-Surgical Registered Nurse	720767	PA
2	363LF0000X	Family Nurse Practitioner	APN.1001679-NP	CO

General Provider Information

NPI Number	:	1285263921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCIA GABRIELA BOTTS RN

Provider Business Mailing Address
First Line	:	162 DEVON WAY
Second Line	:
City	:	LEVITTOWN
State	:	PA
Zip	:	19057-3638
Country	:	US
Telephone Number	:	267-274-8830
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 LANGHORNE NEWTOWN RD
Second Line	:
City	:	LANGHORNE
State	:	PA
Zip	:	19047-1201
Country	:	US
Telephone Number	:	215-710-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2020
Last Update Date	:	02/28/2026

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