Healthcare Provider Details

I. General information

NPI: 1003224940
Provider Name (Legal Business Name): MONICA ELSTON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW # 3PHC
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

32 LEE AVE APT 102
TAKOMA PARK MD
20912-4546
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8531
  • Fax:
Mailing address:
  • Phone: 301-802-0544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1014834
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: