Organization
LCT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI CARMEN CRNA (PRESIDENT)
(505) 747-8639
Entity
Organization
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA, NM 87532-3456
(505) 753-7111
Mailing address
62002 NBU20, ESPANOLA, NM 87532-2711
(505) 747-8639
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17104505
—
NM
01
—
430074229
RAILROAD MEDICARE
NM
01
—
NM006426
BCBS NM GROUP
NM
01
—
NM026426
NM BCBS
NM
Enumeration date
09/14/2005
Last updated
07/21/2022
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