Provider Demographics
NPI:1598127904
Name:MUNOH, MERCY
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:
Last Name:MUNOH
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 1:3415 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20722-1913
Mailing Address - Country:US
Mailing Address - Phone:240-470-8921
Mailing Address - Fax:
Practice Address - Street 1:3415 42ND AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:MD
Practice Address - Zip Code:20722-1913
Practice Address - Country:US
Practice Address - Phone:240-470-8021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11897163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA11897OtherGOVERNMENT OF THE DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH, BOARD OF NURSING