Provider Demographics
NPI:1841825825
Name:LUCERO, SHERRIE LOUISE (PMHNP - APRN)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:LOUISE
Last Name:LUCERO
Suffix:
Gender:F
Credentials:PMHNP - APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 FAR AWAY ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8775
Mailing Address - Country:US
Mailing Address - Phone:702-882-9374
Mailing Address - Fax:
Practice Address - Street 1:5105 CAMINO AL NORTE STE 100
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2373
Practice Address - Country:US
Practice Address - Phone:702-750-2438
Practice Address - Fax:702-750-2173
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV829049363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health