Provider Demographics
NPI:1144710633
Name:LONDONO, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:LONDONO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 JOHNSTOWN CENTER DR UNIT 210
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-7848
Mailing Address - Country:US
Mailing Address - Phone:970-484-8445
Mailing Address - Fax:970-587-4700
Practice Address - Street 1:257 JOHNSTOWN CENTER DR UNIT 210
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-7848
Practice Address - Country:US
Practice Address - Phone:970-484-8445
Practice Address - Fax:970-587-4700
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04G549376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker