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MISS LISA K BUSHNELL C.F.N.P.

Allergy and Immunology

Taos, New Mexico

Provider NPI: 1174524912

Provider Information:
MISS LISA K BUSHNELL C.F.N.P.


Practice Location:
1393 WEIMER RD  TAOS, NM 87571 US
Tel: 575-758-8651  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y364SP0200XPhysician Assistants & Advanced Practice Nursing Providers
Clinical Nurse Specialist
Pediatrics
NMR54485
N207K00000XPhysicians
Allergy & Immunology
NMR54485

Other Provider Identifiers:

IssuerNumberStateType
5670349NM05
00051474NM05
BLUE MEDICARE00NM006H13NM01
CIGNA / LOVELACE1002134201
AETNA772275101
MOLINAQMP00000340456201
BLUE CROSS & BLUE SHIELDNM006H1301
PRESBYTERIAN20202464301
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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