Provider Demographics
NPI:1518375831
Name:LUEVANO, LIBIA A (ND)
Entity Type:Individual
Prefix:
First Name:LIBIA
Middle Name:A
Last Name:LUEVANO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 E. PIMA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-322-9355
Mailing Address - Fax:520-322-9359
Practice Address - Street 1:4008 E. PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:520-322-9355
Practice Address - Fax:520-322-9359
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14-1435175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath