Individual
TINA LUJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
150 BRANNAN RD, TIJERAS, NM 87059-7801
(505) 967-9977
Mailing address
150 BRANNAN RD, TIJERAS, NM 87059-7801
(505) 967-9977
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L20595
NM
Other
Enumeration date
05/04/2010
Last updated
05/04/2010
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