Healthcare Provider Details
I. General information
NPI: 1700770393
Provider Name (Legal Business Name): LUMINAR HEALTH NM LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
227 OXFORD DR
LAS CRUCES NM
88005-1729
US
IV. Provider business mailing address
6082 VIA DE LOS ARBOLES
EL PASO TX
79932-1829
US
V. Phone/Fax
- Phone: 575-270-4453
- Fax:
- Phone: 575-270-4453
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374J00000X |
| Taxonomy | Doula |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174N00000X |
| Taxonomy | Lactation Consultant (Non-RN) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BIANCA
D
BIANCA
Title or Position: FOUNDER
Credential:
Phone: 575-270-4453