Provider Demographics
NPI:1730689704
Name:LUNA, HALEY MICHELLE
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:MICHELLE
Last Name:LUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:HALEY
Other - Middle Name:MICHELLE
Other - Last Name:MEJIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:410 CARTER DR
Mailing Address - Street 2:
Mailing Address - City:DIBOLL
Mailing Address - State:TX
Mailing Address - Zip Code:75941-2502
Mailing Address - Country:US
Mailing Address - Phone:936-404-9120
Mailing Address - Fax:
Practice Address - Street 1:410 CARTER DR
Practice Address - Street 2:
Practice Address - City:DIBOLL
Practice Address - State:TX
Practice Address - Zip Code:75941-2502
Practice Address - Country:US
Practice Address - Phone:936-404-9120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX337571164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse