Provider Demographics
NPI:1689023822
Name:LUNA, LAURIE (FNP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-2622
Mailing Address - Country:US
Mailing Address - Phone:806-765-2611
Mailing Address - Fax:806-853-8736
Practice Address - Street 1:1701 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2701
Practice Address - Country:US
Practice Address - Phone:806-761-0429
Practice Address - Fax:806-712-0084
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily