Healthcare Provider Details

I. General information

NPI: 1306564893
Provider Name (Legal Business Name): LAUREN SUZANNE LUCERO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 MAPLEWOOD AVE UNIT G
RICHMOND VA
23220-5700
US

IV. Provider business mailing address

2420 MAPLEWOOD AVE UNIT G
RICHMOND VA
23220-5700
US

V. Phone/Fax

Practice location:
  • Phone: 804-504-8100
  • Fax: 804-527-5865
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024184887
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: