Provider Demographics
NPI:1609281344
Name:LUJAN, BARBARA (LPN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LUJAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:KAY
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:5505 HADDIX RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-9741
Mailing Address - Country:US
Mailing Address - Phone:937-405-8696
Mailing Address - Fax:
Practice Address - Street 1:5505 HADDIX RD
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-9741
Practice Address - Country:US
Practice Address - Phone:937-405-8696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.153239-MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse