Provider Demographics
NPI:1255756540
Name:DELGADO, LUCIA (RN)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11124 MIRAVISTA PL SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-5996
Mailing Address - Country:US
Mailing Address - Phone:505-620-3460
Mailing Address - Fax:
Practice Address - Street 1:11124 MIRAVISTA PL SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-5996
Practice Address - Country:US
Practice Address - Phone:505-620-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH3173124Q00000X
NMNM-88051163W00000X
NMRN88051163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No124Q00000XDental ProvidersDental Hygienist
No163W00000XNursing Service ProvidersRegistered Nurse