Provider Demographics
NPI:1659559151
Name:LABONTE, MURIEL LINE (RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MURIEL
Middle Name:LINE
Last Name:LABONTE
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 ASHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-5821
Mailing Address - Country:US
Mailing Address - Phone:843-792-5097
Mailing Address - Fax:843-792-3448
Practice Address - Street 1:171 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8908
Practice Address - Country:US
Practice Address - Phone:843-792-5097
Practice Address - Fax:843-792-3448
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily