MEDICARE: MRS. MONICA MICHELLE ENGLESON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2023-086710	NC

General Provider Information

NPI Number	:	1073374484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONICA MICHELLE ENGLESON NP

Provider Business Mailing Address
First Line	:	2109 CRISPLAND CT
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-9420
Country	:	US
Telephone Number	:	843-323-5112
Fax Number	:

Provider Business Practice Location Address
First Line	:	6675 FALLS OF NEUSE RD STE 123
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-6857
Country	:	US
Telephone Number	:	919-999-3604
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2024
Last Update Date	:	01/22/2024

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