Individual
TERRANCE KUSSEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RNWCC
Contact information
Practice address
85 WEST HIGHWAY 22, SANTO DOMINGO PUEBLO, NM 87052
(505) 465-3060
Mailing address
85 WEST HIGHWAY 22, SANTO DOMINGO PUEBLO, NM 87052
(505) 465-3060
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
R52166
NM
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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