Provider Demographics
NPI:1497360226
Name:LUJAN, CINDY RENA (LVN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:RENA
Last Name:LUJAN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 GERMAN POINTER WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-3501
Mailing Address - Country:US
Mailing Address - Phone:817-907-8686
Mailing Address - Fax:
Practice Address - Street 1:3833 GERMAN POINTER WAY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-3501
Practice Address - Country:US
Practice Address - Phone:817-907-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343062164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse