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General NPI Number Information
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NPI Number | 1326380668
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Entity Type | Individual
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Provider Name | MISTY LEE LUCERO CNM
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Gender | Female
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 7 BISBEE RD
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City | BISBEE
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State | AZ
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Zip | 85603-1140
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Country | US
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Telephone | 520-432-5838
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Fax |
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Provider Business Mailing Address
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Address Line | 4403 CORTE BRUMOSO
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-5859
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Country | US
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Telephone | 520-508-1794
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP4897
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP4897
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | AP4897
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License Number State | AZ
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