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General NPI Number Information
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NPI Number | 1750400933
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Entity Type | Individual
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Provider Name | RICKY ALLEN MONETT NP
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 314 W 16TH ST
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City | PUEBLO
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State | CO
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Zip | 81003-2728
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Country | US
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Telephone | 719-546-3511
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Fax | 719-583-1292
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Provider Business Mailing Address
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Address Line | 30691 BARNETT RD
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City | PUEBLO
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State | CO
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Zip | 81006-9544
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Country | US
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Telephone | 719-253-0455
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Fax | 719-546-0330
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 99869
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License Number State | CO
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