Basic Information
| Provider Information | |||||||||
| NPI: | 1154576189 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUCERO | ||||||||
| FirstName: | LINDSEY | ||||||||
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| Credential: | APNP, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3430 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MERRILL | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544529001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153933900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 143 S GIBSON ST | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544511622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7157482121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2008 | ||||||||
| LastUpdateDate: | 02/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WH0200X | 150645-030 | WI | N | Nursing Service Providers | Registered Nurse | Home Health | 363LF0000X | 7259 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.