Provider Demographics
NPI:1598480543
Name:EWING, LUPITA
Entity Type:Individual
Prefix:
First Name:LUPITA
Middle Name:
Last Name:EWING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-1946
Mailing Address - Country:US
Mailing Address - Phone:575-649-8764
Mailing Address - Fax:575-376-7155
Practice Address - Street 1:1201 5TH ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-1946
Practice Address - Country:US
Practice Address - Phone:575-649-8764
Practice Address - Fax:575-376-7155
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker