Provider Demographics
NPI:1710123427
Name:VRAIN, MANON GABRIELLE (RN)
Entity Type:Individual
Prefix:MISS
First Name:MANON
Middle Name:GABRIELLE
Last Name:VRAIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BARNES ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-3406
Mailing Address - Country:US
Mailing Address - Phone:760-967-4634
Mailing Address - Fax:760-967-4450
Practice Address - Street 1:104 BARNES ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3406
Practice Address - Country:US
Practice Address - Phone:760-967-4401
Practice Address - Fax:760-967-4644
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA724402163W00000X
CA74533163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health