Provider Demographics
NPI:1629578463
Name:MOTSWENYANE, MONNYE DORCAS
Entity Type:Individual
Prefix:
First Name:MONNYE
Middle Name:DORCAS
Last Name:MOTSWENYANE
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 1:1410 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76501-1603
Mailing Address - Country:US
Mailing Address - Phone:254-316-2056
Mailing Address - Fax:
Practice Address - Street 1:1410 N 11TH ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76501-1603
Practice Address - Country:US
Practice Address - Phone:254-316-2056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX837747163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse