Provider Demographics
NPI:1942535885
Name:KORNEC, MARIA NOIDA (LVN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:NOIDA
Last Name:KORNEC
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7641 WINTERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2528
Mailing Address - Country:US
Mailing Address - Phone:858-382-6696
Mailing Address - Fax:858-689-6821
Practice Address - Street 1:7641 WINTERWOOD LN
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-2528
Practice Address - Country:US
Practice Address - Phone:858-382-6696
Practice Address - Fax:858-689-6821
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA211139164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse