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General NPI Number Information
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NPI Number | 1841913811
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Entity Type | Individual
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Provider Name | MONICA LYNN EGGEBRECHT RN
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Gender | Female
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 1029 S TRIMBLE RD
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City | MANSFIELD
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State | OH
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Zip | 44906-3427
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Country | US
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Telephone | 419-522-3341
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Fax |
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Provider Business Mailing Address
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Address Line | 43 E BEECHWOLD BLVD
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City | COLUMBUS
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State | OH
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Zip | 43214-2105
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Country | US
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Telephone | 260-452-5049
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 28260659A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APRN.CNP.0034845
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License Number State | OH
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