Individual
CANDICE LUSTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5360 N ACADEMY BLVD STE 290, COLORADO SPRINGS, CO 80918-4038
(719) 434-2061
Mailing address
5360 N ACADEMY BLVD STE 290, COLORADO SPRINGS, CO 80918-4038
(719) 434-2061
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
315646
TX
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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