Doctor Name: | ALYSSA LIGHTBOURN |
NPI Number: | 1477900447 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 788941 |
Business Practice Address: | 305 Alto Vista Dr Sunland Park, NM - 880639116 |
Business Phone Number: | 5755891114 |
Business Fax Number: | |
Mailing Address: | Po Box 70, ANTHONY |
State: | NM |
Postal Code: | 880210070 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/19/2016 |
NPI Last Update Date: | 05/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 788941 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |