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NPI Code Detail

MEDICARE: KRISTIN DIANE LUCIO FNP

MEDICARE: KRISTIN DIANE LUCIO FNP
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
1363LF0000XFamily Nurse PractitionerAP134116TX

General Provider Information

NPI Number : 1639609167
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN DIANE LUCIO FNP
Provider Business Mailing Address
First Line : 3825 SPID DR
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78415-2913
Country : US
Telephone Number : 361-225-0089
Fax Number :
Provider Business Practice Location Address
First Line : 3825 SPID DR
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78415-2913
Country : US
Telephone Number : 361-225-0089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2017
Last Update Date : 06/18/2017

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Directions to “ KRISTIN DIANE LUCIO FNP” Practice Location

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