MEDICARE: MONICA CONSUL

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	163W00000X	Registered Nurse	36863	AK

General Provider Information

NPI Number	:	1346631793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA CONSUL

Provider Business Mailing Address
First Line	:	4511 LAUREL ST
Second Line	:	APT 24
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-1147
Country	:	US
Telephone Number	:	907-782-8033
Fax Number	:

Provider Business Practice Location Address
First Line	:	4511 LAUREL ST
Second Line	:	APT 24
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-1147
Country	:	US
Telephone Number	:	907-782-8033
Fax Number	:

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

Provider Enumeration Date	:	02/06/2015
Last Update Date	:	02/06/2015

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Directions to “ MONICA CONSUL ” Practice Location

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