Provider Demographics
NPI:1891026118
Name:BATEMAN, JUANITA LUNA (BS, LCCE,CLC, CPST)
Entity Type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:LUNA
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:BS, LCCE,CLC, CPST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 110TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:MN
Mailing Address - Zip Code:55920-6223
Mailing Address - Country:US
Mailing Address - Phone:507-244-1562
Mailing Address - Fax:
Practice Address - Street 1:3840 110TH AVE SW
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:MN
Practice Address - Zip Code:55920-6223
Practice Address - Country:US
Practice Address - Phone:507-254-9748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No174H00000XOther Service ProvidersHealth Educator