MEDICARE: YVETTE MARIE LUNA- BOWEN FNP-C

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	363LF0000X	Family Nurse Practitioner	AP131810	TX
2	363LP2300X	Primary Care Nurse Practitioner	AP131810	TX

General Provider Information

NPI Number	:	1497206643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVETTE MARIE LUNA- BOWEN FNP-C

Provider Business Mailing Address
First Line	:	1700 CURIE DR STE 4700
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-2955
Country	:	US
Telephone Number	:	915-532-1197
Fax Number	:	915-532-1198

Provider Business Practice Location Address
First Line	:	1700 CURIE DR STE 4700
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-2955
Country	:	US
Telephone Number	:	915-532-1197
Fax Number	:	915-532-1198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2016
Last Update Date	:	10/21/2016

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