Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN1014834 | DC |
NPI | 1003224940 |
---|---|
Provider Name | Monica Elston |
First Address | Takoma Park, MD 20912-4546 |
Second Address | Washington, DC 20007-2113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 23/07/2014 |