Provider Demographics
NPI:1184104184
Name:MONTEMAYOR, NEREIDA (RN)
Entity type:Individual
Prefix:
First Name:NEREIDA
Middle Name:
Last Name:MONTEMAYOR
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 1:2186 TIMBERLEAF CIR
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362-6214
Mailing Address - Country:US
Mailing Address - Phone:361-523-9531
Mailing Address - Fax:
Practice Address - Street 1:2186 TIMBERLEAF CIR
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362-6214
Practice Address - Country:US
Practice Address - Phone:361-523-9531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-19
Last Update Date:2018-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX945258163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse