Provider Demographics
NPI:1104138742
Name:COLUNGA, KARIN EVE (MSN, RN, CPNP)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:EVE
Last Name:COLUNGA
Suffix:
Gender:F
Credentials:MSN, RN, CPNP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 7270
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92552-7270
Mailing Address - Country:US
Mailing Address - Phone:951-486-5700
Mailing Address - Fax:951-486-5705
Practice Address - Street 1:215 W 4TH ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-2010
Practice Address - Country:US
Practice Address - Phone:951-943-4751
Practice Address - Fax:951-657-3522
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA526820363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics