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General NPI Number Information
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NPI Number | 1083547780
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Entity Type | Individual
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Provider Name | LUCERO PATRICIA GRUMBLES RN
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Gender | Female
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 225 DYER ST FL 3
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City | PROVIDENCE
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State | RI
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Zip | 02903-3927
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Country | US
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Telephone | 401-203-3779
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Fax | 855-710-6476
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Provider Business Mailing Address
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Address Line | 14617 CARLSON ST FL 3
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City | POWAY
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State | CA
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Zip | 92064-3145
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Country | US
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Telephone | 401-203-3779
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Fax | 855-710-6476
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | RN76653
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License Number State | RI
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