Provider Demographics
NPI:1316245376
Name:LUJAN, AMY ELENA (RNFA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELENA
Last Name:LUJAN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9B CAMINITO DE PINON
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1435
Mailing Address - Country:US
Mailing Address - Phone:505-577-0026
Mailing Address - Fax:
Practice Address - Street 1:2990 RODEO PARK DR E
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6302
Practice Address - Country:US
Practice Address - Phone:505-428-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR51694163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant