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Individual
LAKSAMANA PERINTIS NUSANTARA
Active
Individual
LAKSAMANA PERINTIS NUSANTARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
11027192
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
234786
LA
Other
Enumeration date
08/24/2023
Last updated
10/23/2025
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