Provider Demographics
NPI:1861110629
Name:MONSON, MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MONSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4245 N CENTRAL EXPY STE 490
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4231
Mailing Address - Country:US
Mailing Address - Phone:972-454-4511
Mailing Address - Fax:972-808-6771
Practice Address - Street 1:4245 N CENTRAL EXPY STE 490
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-4231
Practice Address - Country:US
Practice Address - Phone:972-454-4511
Practice Address - Fax:972-808-6771
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID73901363LP0808X
OR10030790363LP0808X
TX1086705363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health