Provider Demographics
NPI:1871129205
Name:MUNOZ, STEVEN (LPN)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 PAMPAS PL SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-4424
Mailing Address - Country:US
Mailing Address - Phone:505-263-2567
Mailing Address - Fax:
Practice Address - Street 1:500 MARQUETTE AVE NW STE 1200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-5312
Practice Address - Country:US
Practice Address - Phone:505-429-5750
Practice Address - Fax:505-212-0447
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NML06686164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse