Individual
LARISSA LOSOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8808
Mailing address
4802 53RD ST, LUBBOCK, TX 79414-3708
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
729204
TX
363LN0000X
Neonatal Nurse Practitioner
Primary
AP131769
TX
Other
Enumeration date
06/29/2016
Last updated
11/29/2016
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