MEDICARE: SHANNON MARIE MONCH

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	372500000X	Chore Provider

General Provider Information

NPI Number	:	1891491841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON MARIE MONCH

Provider Business Mailing Address
First Line	:	233 1ST AVE SE
Second Line	:
City	:	BARTON
State	:	ND
Zip	:	58384-5110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 1ST AVE SE
Second Line	:
City	:	BARTON
State	:	ND
Zip	:	58384-5110
Country	:	US
Telephone Number	:	701-776-5391
Fax Number	:

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

Provider Enumeration Date	:	02/01/2023
Last Update Date	:	02/01/2023

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Directions to “ SHANNON MARIE MONCH ” Practice Location

Language	Start Address	Practice Location

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