Provider Demographics
NPI:1144849191
Name:MONROE, JACEY ELIZABETH (RN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JACEY
Middle Name:ELIZABETH
Last Name:MONROE
Suffix:
Gender:F
Credentials:RN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20044 FM 16 W
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-5519
Mailing Address - Country:US
Mailing Address - Phone:469-226-3987
Mailing Address - Fax:
Practice Address - Street 1:7300 ELDORADO PKWY STE 225
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3590
Practice Address - Country:US
Practice Address - Phone:972-893-3376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX887018163WC0200X, 163WH0200X
TX1069770363LP0808X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
2021210051OtherANCC PMHNP-BC CERTIFICATION
TX1069770OtherADVANCED PRACTICE REGISTERED NURSE LICENSE
TX887018OtherREGISTERED NURSE