Provider Demographics
NPI:1962953075
Name:MONTES, MAUREEN (RN)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:MONTES
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 1:8111 SUMMERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9344
Mailing Address - Country:US
Mailing Address - Phone:419-764-2027
Mailing Address - Fax:
Practice Address - Street 1:WASHINGTON JR HIGH SCHOOL
Practice Address - Street 2:5700 WHITMER DR.
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613
Practice Address - Country:US
Practice Address - Phone:419-473-8449
Practice Address - Fax:419-473-8340
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN304141163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse