Provider Demographics
NPI:1871235853
Name:MURAPA, PATIENCE
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:
Last Name:MURAPA
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 1:4708 W DOUGLAS AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-7801
Mailing Address - Country:US
Mailing Address - Phone:206-457-6268
Mailing Address - Fax:
Practice Address - Street 1:4708 W DOUGLAS AVE APT 206
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-7801
Practice Address - Country:US
Practice Address - Phone:206-457-6268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAPA61842363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program