Individual
MR. DUSTIN NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430-0002
(806) 743-1000
Mailing address
6309 95TH ST, LUBBOCK, TX 79424-7597
(404) 430-2242
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP138091
TX
Other
Enumeration date
07/17/2018
Last updated
11/22/2021
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