Individual
VERNA NUSSBAUMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
613 PRAIRIEVIEW DR, CLOVIS, NM 88101-4241
(575) 762-2501
Mailing address
613 PRAIRIEVIEW DR, CLOVIS, NM 88101-4241
(575) 762-2501
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN-21942
NM
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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