Individual
ALLISON M LUELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
15 MARELLA DR, SAN ANTONIO, TX 78248
(317) 417-2269
Mailing address
15 MARELLA DR, SAN ANTONIO, TX 78248-2804
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28147834A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200972050
—
IN
Enumeration date
01/13/2010
Last updated
06/19/2019
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