Provider Demographics
NPI:1164837217
Name:MURUGAVEL, MANIMEGALAI
Entity Type:Individual
Prefix:
First Name:MANIMEGALAI
Middle Name:
Last Name:MURUGAVEL
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 1:9066 GALVIN LN
Mailing Address - Street 2:9066 GALVIN LN
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2945
Mailing Address - Country:US
Mailing Address - Phone:703-822-7489
Mailing Address - Fax:
Practice Address - Street 1:9066 GALVIN LN
Practice Address - Street 2:9066 GALVIN LN
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-2945
Practice Address - Country:US
Practice Address - Phone:703-822-7489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1002285163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator