MEDICARE: LUJAN PSYCHIATRIC SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1457294514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUJAN PSYCHIATRIC SERVICES LLC

Provider Business Mailing Address
First Line	:	3275 W INA RD STE 113
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-2152
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3275 W INA RD STE 113
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-2152
Country	:	US
Telephone Number	:	520-222-8139
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RENEE LUJAN
Credential	:	NP
Telephone Number	:	520-222-8139

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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