Healthcare Provider Details

I. General information

NPI: 1902531999
Provider Name (Legal Business Name): KIANA SUZANNE LUJAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15990 N GREENWAY HAYDEN LOOP STE D100
SCOTTSDALE AZ
85260-2269
US

IV. Provider business mailing address

4111 N 24TH ST
PHOENIX AZ
85016-6222
US

V. Phone/Fax

Practice location:
  • Phone: 877-662-6633
  • Fax:
Mailing address:
  • Phone: 602-381-0696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS025878
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: