Provider Demographics
NPI:1467714394
Name:FRUGE, MONA R (RN)
Entity Type:Individual
Prefix:MS
First Name:MONA
Middle Name:R
Last Name:FRUGE
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:207 GREENSPOINT CMNS
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8009
Mailing Address - Country:US
Mailing Address - Phone:337-262-1935
Mailing Address - Fax:337-262-5237
Practice Address - Street 1:825 KALISTE SALOOM RD
Practice Address - Street 2:BLD III SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4284
Practice Address - Country:US
Practice Address - Phone:337-262-1935
Practice Address - Fax:337-262-5237
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LARN030652163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health