Provider Demographics
NPI:1396052957
Name:LUCESCU, LAVINIA (RN)
Entity type:Individual
Prefix:MISS
First Name:LAVINIA
Middle Name:
Last Name:LUCESCU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1749 N WILLIAMSON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-5219
Mailing Address - Country:US
Mailing Address - Phone:928-717-3263
Mailing Address - Fax:928-717-3262
Practice Address - Street 1:1749 N WILLIAMSON VALLEY RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-5219
Practice Address - Country:US
Practice Address - Phone:928-717-3263
Practice Address - Fax:928-717-3262
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN158894163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool