Provider Demographics
NPI:1033915665
Name:ANTHONY, MONIQUE LASHAWN (LPN)
Entity type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:LASHAWN
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:LASHAWN
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 33401
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-3401
Mailing Address - Country:US
Mailing Address - Phone:770-652-6067
Mailing Address - Fax:
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO337601164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse