Provider Demographics
NPI:1902247463
Name:HALES, MONICA STEPHENSON (FNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:STEPHENSON
Last Name:HALES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 CINCINNATI ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-3007
Mailing Address - Country:US
Mailing Address - Phone:318-878-8965
Mailing Address - Fax:318-878-5599
Practice Address - Street 1:407 CINCINNATI ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-3007
Practice Address - Country:US
Practice Address - Phone:318-878-8965
Practice Address - Fax:318-878-5599
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP07439OtherLICENSE