Provider Demographics
NPI:1609409036
Name:LUZ, MONNICA (APRN)
Entity type:Individual
Prefix:
First Name:MONNICA
Middle Name:
Last Name:LUZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11108 CHENNAULT BEACH RD APT 215
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-4905
Mailing Address - Country:US
Mailing Address - Phone:253-508-7158
Mailing Address - Fax:
Practice Address - Street 1:11108 CHENNAULT BEACH RD APT 215
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-4905
Practice Address - Country:US
Practice Address - Phone:253-508-7158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61229280363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care