Provider Demographics
NPI:1770549925
Name:MONROY, DEBORAH LEE (RNP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LEE
Last Name:MONROY
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-6526
Mailing Address - Country:US
Mailing Address - Phone:951-242-2214
Mailing Address - Fax:
Practice Address - Street 1:245 TERRACINA BLVD
Practice Address - Street 2:SUITE 104-A
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4852
Practice Address - Country:US
Practice Address - Phone:909-748-6065
Practice Address - Fax:909-748-6095
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 400684 RNP3243363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP49519Medicare UPIN
CAZZZ22296ZMedicare ID - Type Unspecified