Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | NP1038477 | DC |
Y | 363LA2200X | Nurse Practitioner - Adult Health | NP1038477 | DC |
N | 363LG0600X | Nurse Practitioner - Gerontology | NP1038477 | DC |
NPI | 1043882111 |
---|---|
Provider Name | Mrs. Monica Elena Baena |
First Address | Washington, DC 20008-1554 |
Second Address | Washington, DC 20037-1434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2021 |
Last Update Date | 11/10/2021 |