Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP143495 | TX |
NPI | 1023652054 |
---|---|
Provider Name | Ariana Lugo |
First Address | El Paso, TX 79932-1820 |
Second Address | El Paso, TX 79902-3320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2019 |
Last Update Date | 02/11/2019 |