Organization
LAZULI THERAPEUTICS, LLC
Active
Other names
LAZULI THERAPEUTICS
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE ELIZABETH MUGAVIN PHD (OWNER)
(505) 508-1167
Entity
Organization
Contact information
Practice address
5800 MCLEOD RD NE STE D, ALBUQUERQUE, NM 87109-2467
(505) 508-1167
(505) 212-0332
Mailing address
PO BOX 14888, ALBUQUERQUE, NM 87191-4888
(505) 508-1167
(505) 212-0332
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417186560
NPI
NM
Enumeration date
01/18/2019
Last updated
05/24/2024
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