Provider Demographics
NPI:1922488659
Name:MUNROE, MARIA ELENA INGALLS (RN)
Entity Type:Individual
Prefix:
First Name:MARIA ELENA
Middle Name:INGALLS
Last Name:MUNROE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARIA ELENA
Other - Middle Name:BRIONES
Other - Last Name:INGALLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17582 ROXANNE LN
Mailing Address - Street 2:APT. A
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-8955
Mailing Address - Country:US
Mailing Address - Phone:714-249-0166
Mailing Address - Fax:
Practice Address - Street 1:17582 ROXANNE LN
Practice Address - Street 2:APT. A
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-8955
Practice Address - Country:US
Practice Address - Phone:714-249-0166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA822095163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse