Provider Demographics
NPI:1497206643
Name:LUNA- BOWEN, YVETTE MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:MARIE
Last Name:LUNA- BOWEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 CURIE DR STE 4700
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2955
Mailing Address - Country:US
Mailing Address - Phone:915-532-1197
Mailing Address - Fax:915-532-1198
Practice Address - Street 1:1700 CURIE DR STE 4700
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2955
Practice Address - Country:US
Practice Address - Phone:915-532-1197
Practice Address - Fax:915-532-1198
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131810363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care