Provider Demographics
NPI:1396995775
Name:LUJAN, ELICIA ANN (CFNP)
Entity type:Individual
Prefix:
First Name:ELICIA
Middle Name:ANN
Last Name:LUJAN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-6390 KAPOLEI PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6380
Mailing Address - Country:US
Mailing Address - Phone:808-691-8200
Mailing Address - Fax:
Practice Address - Street 1:91-6390 KAPOLEI PKWY STE 200
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-6380
Practice Address - Country:US
Practice Address - Phone:808-691-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily