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NPI Code Detail

MEDICARE: JAZMIN LUCERO

MEDICARE:   JAZMIN  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 WorkerCCSSNM

General Provider Information

NPI Number : 1720919673
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAZMIN LUCERO
Provider Business Mailing Address
First Line : 9201 MONTGOMERY BLVD NE STE V
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-2470
Country : US
Telephone Number : 505-507-7984
Fax Number :
Provider Business Practice Location Address
First Line : 9201 MONTGOMERY BLVD NE STE V
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-2470
Country : US
Telephone Number : 505-507-7984
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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Directions to “ JAZMIN LUCERO ” Practice Location

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