Provider Demographics
NPI:1821663576
Name:MUNROSE, SHELIA DIANN (RN)
Entity Type:Individual
Prefix:
First Name:SHELIA
Middle Name:DIANN
Last Name:MUNROSE
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 1:10511 BUCKEYE ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77523-0815
Mailing Address - Country:US
Mailing Address - Phone:281-851-4608
Mailing Address - Fax:
Practice Address - Street 1:10511 BUCKEYE ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77523-0815
Practice Address - Country:US
Practice Address - Phone:281-851-4608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679488171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator