Provider Demographics
NPI:1568237485
Name:LUCERO, ASHLEA MARIA (FNP-C, RN)
Entity Type:Individual
Prefix:
First Name:ASHLEA
Middle Name:MARIA
Last Name:LUCERO
Suffix:
Gender:F
Credentials:FNP-C, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 EUBANK BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3590
Mailing Address - Country:US
Mailing Address - Phone:505-292-8575
Mailing Address - Fax:505-292-8409
Practice Address - Street 1:3825 EUBANK BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3590
Practice Address - Country:US
Practice Address - Phone:505-292-8575
Practice Address - Fax:505-292-8409
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM76832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily