Provider Demographics
NPI:1962890087
Name:NAVARRO, MARIA (RN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:NAVARRO
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 1:1405 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:TOPPENISH
Mailing Address - State:WA
Mailing Address - Zip Code:98948-1005
Mailing Address - Country:US
Mailing Address - Phone:509-910-9505
Mailing Address - Fax:888-402-4694
Practice Address - Street 1:1405 BONNIE LN
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-1005
Practice Address - Country:US
Practice Address - Phone:509-910-9505
Practice Address - Fax:888-402-4694
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN0118748163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1115617Medicaid