Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP113437 | TX |
NPI | 1093777831 |
---|---|
Provider Name | Gayette Lyn Huseby |
First Address | El Paso, TX 79922-1913 |
Second Address | El Paso, TX 79902-3351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 14/11/2019 |