MEDICARE: MONNAKA SPEIGHTS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1-116467	AL

General Provider Information

NPI Number	:	1538740246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONNAKA SPEIGHTS NP

Provider Business Mailing Address
First Line	:	1165 DUBLIN RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-1005
Country	:	US
Telephone Number	:	614-859-1500
Fax Number	:	614-221-1454

Provider Business Practice Location Address
First Line	:	1165 DUBLIN RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-1005
Country	:	US
Telephone Number	:	614-859-1500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2021
Last Update Date	:	04/15/2021

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Directions to “ MONNAKA SPEIGHTS NP” Practice Location

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