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General NPI Number Information
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NPI Number | 1487201034
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Entity Type | Individual
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Provider Name | CARRIE LUJAN PMHNP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 1001 CECELIA DR STE 200
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City | PEWAUKEE
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State | WI
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Zip | 53072-2500
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Country | US
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Telephone | 262-260-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 S COLORADO BLVD STE 810
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City | DENVER
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State | CO
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Zip | 80222-3351
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Country | US
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Telephone | 303-223-6326
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 9486
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0995162
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License Number State | CO
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