Individual
ALYSSA LIGHTBOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
305 ALTO VISTA DR, SUNLAND PARK, NM 88063-9116
(575) 589-1114
Mailing address
PO BOX 70, ANTHONY, NM 88021-0070
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
788941
TX
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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