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NPI Code Detail

MEDICARE: EWELINA LUCARELLI

MEDICARE: EWELINA LUCARELLI
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner247177AZ

General Provider Information

NPI Number : 1730796251
Entity Type Code : Individual
Provider Name (Legal Business Name) : EWELINA LUCARELLI
Provider Business Mailing Address
First Line : 1509 E CAMPBELL AVE
Second Line :
City : GILBERT
State : AZ
Zip : 85234-4815
Country : US
Telephone Number : 480-658-9640
Fax Number :
Provider Business Practice Location Address
First Line : 4330 E UNIVERSITY DR
Second Line :
City : MESA
State : AZ
Zip : 85205-7004
Country : US
Telephone Number : 480-218-3280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2020
Last Update Date : 09/29/2020

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Directions to “ EWELINA LUCARELLI ” Practice Location

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