Shannon Albina Lujan, RN BSN

Individual provider Active NPI Community Health Registered Nurse · Taos, NM

NPI 1396124244 · NPPES record last updated May 26, 2015

Key facts

NPI
1396124244
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
R64779 (NM)
Practice address
230 Rotten Tree Road
Taos, NM 87571
Phone
(575) 758-7824
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R64779NMMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Taos Pueblo CMS Administration Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R64779 NM Yes

Addresses

Primary practice location

230 Rotten Tree Road
Taos, NM 87571

Mailing address

P.O Box 161
Taos, NM 87571
Phone (575) 770-5626

Other providers in Taos, NM

All providers in Taos, NM · Community Health Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.