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General NPI Number Information
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NPI Number | 1194768226
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Entity Type | Individual
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Provider Name | CHRISTA MONROE NP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 12/10/2015
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Provider Practice Location Address
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Address Line | 1099 MEDICAL CENTER CIR
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City | MAYFIELD
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State | KY
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Zip | 42066-1159
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Country | US
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Telephone | 800-893-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 76 OLD PENNY RD
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City | HARDIN
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State | KY
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Zip | 42048-9613
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Country | US
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Telephone | 270-293-7547
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4489P
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License Number State | KY
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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 | 3004489
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License Number State | KY
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