Provider Demographics
NPI:1235903865
Name:ORTIZ, LUCIA MEJORADO (FNP)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:MEJORADO
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3637 UTAH LN
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-2006
Mailing Address - Country:US
Mailing Address - Phone:661-378-7453
Mailing Address - Fax:
Practice Address - Street 1:6001 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0679
Practice Address - Country:US
Practice Address - Phone:661-978-8007
Practice Address - Fax:661-833-3037
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF95022936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily