Healthcare Provider Details

I. General information

NPI: 1568956381
Provider Name (Legal Business Name): YVONNE I MONIEN MSN, RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E 4TH ST
DULUTH MN
55805-2147
US

IV. Provider business mailing address

1500 N 34TH ST STE 100
SUPERIOR WI
54880-4476
US

V. Phone/Fax

Practice location:
  • Phone: 218-728-3931
  • Fax: 218-302-8728
Mailing address:
  • Phone: 715-392-8216
  • Fax: 715-392-6055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number111095
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2266761
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: