Provider Demographics
NPI:1770372351
Name:LUMA NOVA LEARNING CIRCLE
Entity type:Organization
Organization Name:LUMA NOVA LEARNING CIRCLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:KALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:PULTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-243-5001
Mailing Address - Street 1:406 S LEA AVE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-4564
Mailing Address - Country:US
Mailing Address - Phone:575-243-5001
Mailing Address - Fax:575-616-7006
Practice Address - Street 1:406 S LEA AVE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4564
Practice Address - Country:US
Practice Address - Phone:575-243-5001
Practice Address - Fax:575-616-7006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty