| Doctor Name: | MR. EDWARD RAY LOBAUGH |
| NPI Number: | 1588686158 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CNP, CNS, APRN BC |
| License Number: | R45675 |
| Business Practice Address: | 1701 Old Route 66 Suite D Moriarty, NM - 87035 |
| Business Phone Number: | 5052651711 |
| Business Fax Number: | |
| Mailing Address: | Po Box 3823, MORIARTY |
| State: | NM |
| Postal Code: | 870353823 |
| Phone Number: | 5053841034 |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2006 |
| NPI Last Update Date: | 08/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R45675 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |