Provider Demographics
NPI:1093310377
Name:VANUNU, LIZETTE ARLYNN (RN)
Entity Type:Individual
Prefix:
First Name:LIZETTE
Middle Name:ARLYNN
Last Name:VANUNU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29012
Mailing Address - Street 2:REDONDO SHORES DR S
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198
Mailing Address - Country:US
Mailing Address - Phone:253-332-0958
Mailing Address - Fax:253-929-8100
Practice Address - Street 1:29012
Practice Address - Street 2:REDONDO SHORES DR S
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198
Practice Address - Country:US
Practice Address - Phone:253-332-0958
Practice Address - Fax:253-929-8100
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00088070163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse