Provider Demographics
NPI:1518772714
Name:MONROE, LATEACIA
Entity type:Individual
Prefix:
First Name:LATEACIA
Middle Name:
Last Name:MONROE
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 1:1111 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-6013
Mailing Address - Country:US
Mailing Address - Phone:402-500-9610
Mailing Address - Fax:
Practice Address - Street 1:7421 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68507-2955
Practice Address - Country:US
Practice Address - Phone:531-333-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion