MEDICARE: JULIA L LUEVANOS FNP

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	239995	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669097051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA L LUEVANOS FNP

Provider Business Mailing Address
First Line	:	675 S AVENUE B BLDG A
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-2749
Country	:	US
Telephone Number	:	928-539-3140
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 S AVENUE B BLDG A
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-2749
Country	:	US
Telephone Number	:	928-539-3140
Fax Number	:

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

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	01/11/2024

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