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NPI Code Detail

MEDICARE: ANTOINETTE LUCERO

MEDICARE: ANTOINETTE LUCERO
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
1172V00000XCommunity Health WorkerNM

General Provider Information

NPI Number : 1508262692
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTOINETTE LUCERO
Provider Business Mailing Address
First Line : 13139 CENTRAL AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87123-3031
Country : US
Telephone Number : 505-575-1607
Fax Number :
Provider Business Practice Location Address
First Line : 13139 CENTRAL AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87123-3031
Country : US
Telephone Number : 505-575-1607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2014
Last Update Date : 02/11/2026

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Directions to “ ANTOINETTE LUCERO ” Practice Location

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