Provider Demographics
NPI:1346669090
Name:LUCIO, SCHUYLER
Entity Type:Individual
Prefix:
First Name:SCHUYLER
Middle Name:
Last Name:LUCIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SCHUYLER
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1916 20TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3712
Mailing Address - Country:US
Mailing Address - Phone:202-503-7646
Mailing Address - Fax:
Practice Address - Street 1:1916 20TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3712
Practice Address - Country:US
Practice Address - Phone:202-503-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18252363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health