Healthcare Provider Details

I. General information

NPI: 1881483097
Provider Name (Legal Business Name): ERIN ELIZABETH LUCERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1281 E COTTONWOOD LN
CASA GRANDE AZ
85122-2949
US

IV. Provider business mailing address

8625 E BELLEVIEW PL UNIT 1072
SCOTTSDALE AZ
85257-4149
US

V. Phone/Fax

Practice location:
  • Phone: 520-836-9800
  • Fax:
Mailing address:
  • Phone: 505-803-2705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: