Provider Demographics
NPI:1962009613
Name:LOGUERCIO, LINDSAY MARGARET
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARGARET
Last Name:LOGUERCIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MARAVILLA CT
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1847
Mailing Address - Country:US
Mailing Address - Phone:505-507-7376
Mailing Address - Fax:
Practice Address - Street 1:4 MARAVILLA CT
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1847
Practice Address - Country:US
Practice Address - Phone:505-507-7376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA840146163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse