Lucindy Anderson-Brown
Individual provider Active NPI Nurse Practitioner · Peoria, AZ
NPI 1609560010 · NPPES record last updated Jun 7, 2023
Key facts
- NPI
- 1609560010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RNP291825 (AZ)
- Practice address
- 9015 W Union Hills Dr Ste 107
Peoria, AZ 85382-3106 - Phone
- (623) 313-2910
- NPI assigned
- Jun 7, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250610000554 | AZ | Practitioner - Nurse Practitioner | 4688184617 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RNP291825 | AZ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Espoir Medical Group LLC | Current |
Accepting new patients |
Locations
9015 W Union Hills Dr
Ste 107
Peoria, AZ 85382
Phone (602) 560-9925
9015 W Union Hills Dr
Ste 107B
Peoria, AZ 85382
Phone (623) 404-4474
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RNP291825 | AZ | Yes |
Addresses
Primary practice location
9015 W Union Hills Dr Ste 107
Peoria, AZ 85382-3106
Mailing address
9015 W Union Hills Dr Ste 107
Peoria, AZ 85382-3106
Phone (623) 313-2910
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.