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NPI Code Detail

MEDICARE: LISETTE CAMPOS CUEVAS FNP

MEDICARE: LISETTE CAMPOS CUEVAS FNP
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
1363LF0000XFamily Nurse Practitioner95019275CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871244798
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISETTE CAMPOS CUEVAS FNP
Provider Business Mailing Address
First Line : 450 E BIRCH ST
Second Line :
City : CALEXICO
State : CA
Zip : 92231-2375
Country : US
Telephone Number : 760-925-7651
Fax Number :
Provider Business Practice Location Address
First Line : 450 E BIRCH ST
Second Line :
City : CALEXICO
State : CA
Zip : 92231-2375
Country : US
Telephone Number : 760-351-3296
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2022
Last Update Date : 04/11/2022

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Directions to “ LISETTE CAMPOS CUEVAS FNP” Practice Location

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