Provider Demographics
NPI:1962903955
Name:MUNOZ, KATLIN MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:KATLIN
Middle Name:MICHELLE
Last Name:MUNOZ
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 1:1332 MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-3801
Mailing Address - Country:US
Mailing Address - Phone:817-372-0092
Mailing Address - Fax:
Practice Address - Street 1:1332 MISSOURI ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-3801
Practice Address - Country:US
Practice Address - Phone:817-372-0092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-24
Last Update Date:2018-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX891637163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse