Provider Demographics
NPI:1144535113
Name:MONROE, JAMIE SUE (RN)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:SUE
Last Name:MONROE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20750 KEITH PERSON RD
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-8550
Mailing Address - Country:US
Mailing Address - Phone:479-208-0833
Mailing Address - Fax:
Practice Address - Street 1:10110 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2173
Practice Address - Country:US
Practice Address - Phone:501-227-9700
Practice Address - Fax:501-227-9727
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR64526163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical