Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP02119 | LA |
NPI | 1023300845 |
---|---|
Provider Name | Michelle Lusco Cambias |
First Address | Houston, TX 77210-4869 |
Second Address | Baton Rouge, LA 70809-3679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2011 |
Last Update Date | 12/05/2011 |