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General NPI Number Information
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NPI Number | 1174048474
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Entity Type | Individual
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Provider Name | MONIQUE JENNIFER STAGE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 11459 JOHNS CREEK PKWY STE 250
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City | JOHNS CREEK
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State | GA
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Zip | 30097-3517
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Country | US
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Telephone | 770-497-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 8535 SWISS AIR PT
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City | GAINESVILLE
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State | GA
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Zip | 30506-4873
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Country | US
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Telephone | 470-926-8543
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11037343
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 24190071
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0036230
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 121410
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License Number State | WV
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP030761
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 101.0137041
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License Number State | VT
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN266890
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 81134
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License Number State | NM
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