Healthcare Provider Details
I. General information
NPI: 1245036334
Provider Name (Legal Business Name): MONARCH MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7986 S ORILLA RD
CUMMING IA
50061-5807
US
IV. Provider business mailing address
PO BOX 131
CUMMING IA
50061-0131
US
V. Phone/Fax
- Phone: 515-200-2124
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
JETTER
Title or Position: OWNER
Credential: ARNP
Phone: 515-238-2339