Individual
TAYLOR LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 ROAD 1497, LA PLATA, NM 87418-9630
(505) 215-1182
Mailing address
5 ROAD 1497, LA PLATA, NM 87418-9630
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
65553
NM
Other
Enumeration date
02/25/2022
Last updated
02/25/2022
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