Individual
MALLORY MUNROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, WHNP-BC
Contact information
Practice address
16105 SAND CANYON AVE STE 200, IRVINE, CA 92618-3779
(949) 829-5500
Mailing address
674 W 18TH ST APT A, COSTA MESA, CA 92627-5018
(657) 600-1174
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
95019413
CA
367A00000X
Advanced Practice Midwife
Primary
236234
CA
Other
Enumeration date
12/14/2021
Last updated
12/14/2021
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