Provider Demographics
NPI:1972357408
Name:MCMASTERS, MARIA CARMEN REYES (RN)
Entity type:Individual
Prefix:
First Name:MARIA CARMEN
Middle Name:REYES
Last Name:MCMASTERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARIA CARMEN
Other - Middle Name:REYES
Other - Last Name:LAKATOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:540821 LEM TURNER RD
Mailing Address - Street 2:
Mailing Address - City:CALLAHAN
Mailing Address - State:FL
Mailing Address - Zip Code:32011-7724
Mailing Address - Country:US
Mailing Address - Phone:951-599-3673
Mailing Address - Fax:
Practice Address - Street 1:30 MCGHEE RD STE 101
Practice Address - Street 2:
Practice Address - City:KOOTENAI
Practice Address - State:ID
Practice Address - Zip Code:83840-0030
Practice Address - Country:US
Practice Address - Phone:208-263-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9574857163WA2000X, 163W00000X
CA827997163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator