Provider Demographics
NPI:1255707048
Name:NUNEZ, DEMETRIA GERMAINE
Entity type:Individual
Prefix:MS
First Name:DEMETRIA
Middle Name:GERMAINE
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DEMETRIA
Other - Middle Name:GERMAINE
Other - Last Name:NUNEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10907 SHANNA DR
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-6331
Mailing Address - Country:US
Mailing Address - Phone:337-517-7933
Mailing Address - Fax:337-385-2599
Practice Address - Street 1:10907 SHANNA DR
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-6331
Practice Address - Country:US
Practice Address - Phone:337-517-7933
Practice Address - Fax:337-385-2599
Is Sole Proprietor?:No
Enumeration Date:2015-08-15
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion