Provider Demographics
NPI:1083339881
Name:ARNUEVO, EUNICE MONDELO
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:MONDELO
Last Name:ARNUEVO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 BORBECK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3725
Mailing Address - Country:US
Mailing Address - Phone:445-255-4288
Mailing Address - Fax:
Practice Address - Street 1:2108 BORBECK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3725
Practice Address - Country:US
Practice Address - Phone:445-255-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN764160163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse