Healthcare Provider Details

I. General information

NPI: 1215673025
Provider Name (Legal Business Name): ALMA ALICIA LUJAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALMA ALICIA RODRIGUEZ-FLORES

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 LAS ESTANCIAS DR SW
ALBUQUERQUE NM
87121-5504
US

IV. Provider business mailing address

3630 LAS ESTANCIAS DR SW
ALBUQUERQUE NM
87121-5504
US

V. Phone/Fax

Practice location:
  • Phone: 505-462-7777
  • Fax:
Mailing address:
  • Phone: 505-462-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number67926
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: