Provider Demographics
NPI:1114331311
Name:LUNA, ANN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MISS
First Name:ANN
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 EASTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-3342
Mailing Address - Country:US
Mailing Address - Phone:936-327-7147
Mailing Address - Fax:936-328-5216
Practice Address - Street 1:219 EASTWOOD AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-3342
Practice Address - Country:US
Practice Address - Phone:936-327-7147
Practice Address - Fax:936-328-5216
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125782363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner