Provider Demographics
NPI:1467841783
Name:TABOADA, LUZ CONNY (ARNP)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:CONNY
Last Name:TABOADA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 S US HIGHWAY 83
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-2213
Mailing Address - Country:US
Mailing Address - Phone:956-649-5069
Mailing Address - Fax:
Practice Address - Street 1:7210 S US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-2213
Practice Address - Country:US
Practice Address - Phone:956-649-5069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9281473363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily