Individual
KYLE RICHARD LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
211 SUDDERTH DR, RUIDOSO, NM 88345-6043
(575) 257-8200
Mailing address
137 DANCING STAR TRL, ALTO, NM 88312-9522
(575) 937-8303
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
251088
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA-01535
NM
Other
Enumeration date
09/22/2017
Last updated
09/19/2021
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