Individual
BRENDA J LUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
840 E UNIVERSITY AVE, DES MOINES, IA 50316-2304
(515) 265-4211
Mailing address
810 PIERCE ST, IOWA FALLS, IA 50126-1417
(515) 480-3845
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
105583
IA
363AM0700X
Medical Physician Assistant
105583
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2020
Last updated
02/05/2024
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