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Individual
MYRA BUSTAMANTE
Active
Individual
MYRA BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LP034207
AZ
164X00000X
Licensed Vocational Nurse
Primary
VN682197
CA
Other
Enumeration date
06/09/2011
Last updated
04/20/2016
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