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General NPI Number Information
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NPI Number | 1184453359
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Entity Type | Individual
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Provider Name | JESSICA MONROIG NNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/29/2024
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 901 E 5TH ST
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City | WASHINGTON
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State | MO
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Zip | 63090-3127
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Country | US
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Telephone | 636-239-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 776084
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City | CHICAGO
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State | IL
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Zip | 60677-6084
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Country | US
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Telephone | 636-390-8555
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Fax | 636-390-9444
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 2024032100
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License Number State | MO
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