Healthcare Provider Details

I. General information

NPI: 1770788416
Provider Name (Legal Business Name): MRS. MONICA JOAN MENTZER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MONICA JOAN SWEDA

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HARRY S TRUMAN PKWY ANNE ARUNDEL COUNTY DEPT OF HEALTH SUITE 231
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

1329 FARLEY CT SOUTH
ARNOLD MD
21012
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-7256
  • Fax: 410-222-7490
Mailing address:
  • Phone: 410-222-7256
  • Fax: 410-222-7490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR114269
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: