Provider Demographics
NPI:1104883651
Name:TALUSAN, RICHARD LUNA (NP)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LUNA
Last Name:TALUSAN
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Gender:M
Credentials:NP
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Mailing Address - Street 1:7235 S BUFFALO DR
Mailing Address - Street 2:VA SOUTHWEST PRIMARY CARE CLINIC
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-4040
Mailing Address - Country:US
Mailing Address - Phone:702-791-9040
Mailing Address - Fax:702-365-3093
Practice Address - Street 1:7235 S BUFFALO DR
Practice Address - Street 2:VA SOUTHWEST PRIMARY CARE CLINIC
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4040
Practice Address - Country:US
Practice Address - Phone:702-791-9040
Practice Address - Fax:702-365-3093
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2013-05-31
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Provider Licenses
StateLicense IDTaxonomies
NVNV000766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily