Provider Demographics
NPI:1154843936
Name:MUNOZ, PAOLA ANDREA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:PAOLA
Middle Name:ANDREA
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:PAOLA
Other - Middle Name:ANDREA
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8602
Mailing Address - Fax:
Practice Address - Street 1:877 W FARIS RD STE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4296
Practice Address - Country:US
Practice Address - Phone:864-455-9031
Practice Address - Fax:864-455-9014
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60767021363LP2300X
SC20955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care