Individual
JESSICA LUJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1130 W PRAIRIE AVE, COEUR D ALENE, ID 83815-8780
(208) 209-0288
(208) 209-0289
Mailing address
303 PASEO DE PERALTA, SANTA FE, NM 87501-1860
(505) 988-2449
(505) 819-0588
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
57250
NM
363LF0000X
Family Nurse Practitioner
Primary
71672
ID
Other
Enumeration date
08/07/2019
Last updated
03/31/2022
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