Provider Demographics
NPI:1861618274
Name:MONK, MARY ELIZABETH (CNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:MONK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6667 HIGHPOINT BLVD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9031
Mailing Address - Country:US
Mailing Address - Phone:513-737-6028
Mailing Address - Fax:
Practice Address - Street 1:16 EAST MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ADDYSTON
Practice Address - State:OH
Practice Address - Zip Code:45001
Practice Address - Country:US
Practice Address - Phone:513-941-8300
Practice Address - Fax:513-941-8340
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN173312363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health