Individual
LUIZ JUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
2605 GAULT AVE N STE 200, FORT PAYNE, AL 35967-3700
(256) 996-9121
Mailing address
100 FOREST AVE NW, FORT PAYNE, AL 35967-2054
(256) 996-9121
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1-132461
AL
363LF0000X
Family Nurse Practitioner
Primary
1-132461
AL
364SA2200X
Adult Health Clinical Nurse Specialist
1-132461
AL
364SG0600X
Gerontology Clinical Nurse Specialist
1-132461
AL
Other
Enumeration date
02/17/2017
Last updated
10/07/2022
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