Healthcare Provider Details

I. General information

NPI: 1184510133
Provider Name (Legal Business Name): KAREN ANN LUJAN CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 C 5TH ST, PO BOX 807
ESTANCIA NM
87016
US

IV. Provider business mailing address

903 C 5TH ST, PO BOX 807
ESTANCIA NM
87016
US

V. Phone/Fax

Practice location:
  • Phone: 505-384-2777
  • Fax: 505-443-8387
Mailing address:
  • Phone: 505-384-2777
  • Fax: 505-443-8387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: