Provider Demographics
NPI:1770526733
Name:FORBES, MONICA (PA-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:FORBES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50428-2304
Mailing Address - Country:US
Mailing Address - Phone:641-357-1800
Mailing Address - Fax:641-357-1803
Practice Address - Street 1:401 S 17TH ST
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428-2304
Practice Address - Country:US
Practice Address - Phone:641-357-1800
Practice Address - Fax:641-357-1803
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000918363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0424507Medicaid
IA0600460Medicaid
IA0635011Medicaid
IA0655001Medicaid
IA29352OtherBCBS ER
IA0283465Medicaid
IA60046OtherBCBS REG
IA33444OtherFPC BCBS NRH
IA36174OtherBCBS DME
IA0293522Medicaid
IA66046OtherBCBS SNF
IACE8231Medicare Oscar/Certification
IA16Z302Medicare Oscar/Certification
IA0600460Medicaid
IADA1838Medicare ID - Type UnspecifiedFPC MEDICARE RR
IA0283465Medicaid
IA29352OtherBCBS ER
IA66046OtherBCBS SNF
IA0293522Medicaid