Provider Demographics
NPI:1790107688
Name:LUSCHEI, EDAN (RN)
Entity Type:Individual
Prefix:
First Name:EDAN
Middle Name:
Last Name:LUSCHEI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 N ARMIJO ST
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2120
Mailing Address - Country:US
Mailing Address - Phone:575-527-9430
Mailing Address - Fax:575-527-9444
Practice Address - Street 1:5700 MESA GRANDE DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-6017
Practice Address - Country:US
Practice Address - Phone:575-527-9430
Practice Address - Fax:575-571-9444
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR31407163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool