Provider Demographics
NPI:1386123941
Name:LUNA, LUZ ELENA (LVN)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:ELENA
Last Name:LUNA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:LUZ
Other - Middle Name:ELENA
Other - Last Name:LUNA RICO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:1124 15TH ST SE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-7533
Mailing Address - Country:US
Mailing Address - Phone:903-495-9723
Mailing Address - Fax:
Practice Address - Street 1:11245 15 ST SE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460
Practice Address - Country:US
Practice Address - Phone:903-495-9723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344075164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse