Provider Demographics
NPI:1881347516
Name:APOLINARIO, MERIAN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:MERIAN
Middle Name:
Last Name:APOLINARIO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13193 CENTRAL AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4179
Mailing Address - Country:US
Mailing Address - Phone:095-910-8439
Mailing Address - Fax:909-591-7226
Practice Address - Street 1:13193 CENTRAL AVE STE 220
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4179
Practice Address - Country:US
Practice Address - Phone:909-591-0843
Practice Address - Fax:909-591-7226
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019895363LA2100X
CANP95019895363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty