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General NPI Number Information
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NPI Number | 1851642219
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Entity Type | Individual
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Provider Name | RAUL LUEVANO FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 698 FAIRVIEW RD
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City | SIMPSONVILLE
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State | SC
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Zip | 29860
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Country | US
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Telephone | 540-678-4895
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Fax |
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Provider Business Mailing Address
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Address Line | 698 FAIRVIEW RD
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6708
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 18063
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5008536
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024170350
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License Number State | VA
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