ELIZABETH ANN FULFORD

LAS CRUCES, NM
NPI1386365401
Former NameELIZABETH VANDENBROUCK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: NM  68003)
Additional Taxonomies163W00000X Registered Nurse
(Licence: NM  68003)
390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL  041470039)
Enumeration Date2022-09-07
Last Update Date2023-01-26
Business Address
ELIZABETH ANN FULFORD
2450 S TELSHOR BLVD
LAS CRUCES, NM 88011-5069
Phone number: 575-522-8641
Mailing Address
ELIZABETH ANN FULFORD
4565 MESA CORTA DR
LAS CRUCES, NM 88011-6040
Phone number: 586-876-1405