MEDICARE: MONETTE WELLNESS CARE SERVICES LLC

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

General Provider Information

NPI Number	:	1306664388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONETTE WELLNESS CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	2416 CANTERBURY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-4911
Country	:	US
Telephone Number	:	513-888-7851
Fax Number	:

Provider Business Practice Location Address
First Line	:	2416 CANTERBURY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-4911
Country	:	US
Telephone Number	:	513-888-7851
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MONETTE PAR
Credential	:	APRN
Telephone Number	:	513-888-7851

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	09/30/2024

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