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General NPI Number Information
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NPI Number | 1164235636
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Entity Type | Organization
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Legal Business Name | THE LUMA CONNECTION PLLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 4601 LOMA DEL REY CIR
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City | EL PASO
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State | TX
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Zip | 79934-4110
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Country | US
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Telephone | 336-303-8415
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Fax |
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Provider Business Mailing Address
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Address Line | 1633 NEW GARDEN RD UNIT 373
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City | GREENSBORO
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State | NC
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Zip | 27410-2001
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Country | US
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Telephone | 336-303-8415
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LINDA BANKS
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Credential |
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Telephone | 336-905-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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