Provider Demographics
NPI:1033394135
Name:LONDON, LUCIA C (ARNP)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:C
Last Name:LONDON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LUCIA
Other - Middle Name:M
Other - Last Name:CALANDRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 40000
Mailing Address - Street 2:OCCUPATIONAL HEALTH
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81658
Mailing Address - Country:US
Mailing Address - Phone:970-569-7715
Mailing Address - Fax:970-470-6697
Practice Address - Street 1:230 CHAPEL PLACE
Practice Address - Street 2:UNIT D101
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620
Practice Address - Country:US
Practice Address - Phone:970-569-7715
Practice Address - Fax:970-470-6697
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1008572363LF0000X
CO990352363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3088669-00Medicaid
GA480469761AMedicaid
FL3088669-00Medicaid
FLAI301ZMedicare PIN