Provider Demographics
NPI:1528176948
Name:LUJAN, GILBERT CIPRIANO (RN)
Entity type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:CIPRIANO
Last Name:LUJAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:GILBERT
Other - Middle Name:CIPRIANO
Other - Last Name:LUJAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:35 CLARENCES RD
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-7683
Mailing Address - Country:US
Mailing Address - Phone:505-861-6807
Mailing Address - Fax:
Practice Address - Street 1:1501 SAN PEDRO DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5153
Practice Address - Country:US
Practice Address - Phone:505-265-1711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR32822163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health