Provider Demographics
NPI:1861902322
Name:JONES, MONIQUE N (MSN, RN, FNP-C)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:
Other - Last Name:FULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, FNP-C
Mailing Address - Street 1:7030 HELEN ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2211
Mailing Address - Country:US
Mailing Address - Phone:248-943-8701
Mailing Address - Fax:
Practice Address - Street 1:30920 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-7738
Practice Address - Country:US
Practice Address - Phone:248-647-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704242970163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse