Provider Demographics
NPI:1609080662
Name:LUNA, LANE C (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LANE
Middle Name:C
Last Name:LUNA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LANE
Other - Middle Name:A
Other - Last Name:CAMERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4623 COUNTY ROAD 103
Mailing Address - Street 2:
Mailing Address - City:LAMPASAS
Mailing Address - State:TX
Mailing Address - Zip Code:76550-9754
Mailing Address - Country:US
Mailing Address - Phone:210-383-7199
Mailing Address - Fax:
Practice Address - Street 1:4623 COUNTY ROAD 103
Practice Address - Street 2:
Practice Address - City:LAMPASAS
Practice Address - State:TX
Practice Address - Zip Code:76550-9754
Practice Address - Country:US
Practice Address - Phone:210-383-7199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP110539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily