Healthcare Provider Details

I. General information

NPI: 1962114868
Provider Name (Legal Business Name): DANIELLE N MONKAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 STONE MEADOW CT
FAIRFIELD OH
45014-9115
US

IV. Provider business mailing address

45 STONE MEADOW CT
FAIRFIELD OH
45014-9115
US

V. Phone/Fax

Practice location:
  • Phone: 513-805-9845
  • Fax:
Mailing address:
  • Phone: 513-805-9845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: